American Journal of Epidemiology Advance Access originally published online on February 6, 2008
American Journal of Epidemiology 2008 167(8):998-1004; doi:10.1093/aje/kwm393
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ORIGINAL CONTRIBUTIONS |
Risk Factors for Chronic Obstructive Pulmonary Disease Mortality in Chinese Adults
1 Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA
2 Department of Evidence Based Medicine, Cardiovascular Institute and Fu Wai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, and National Center for Cardiovascular Diseases, Beijing, China
3 Guangdong Provincial People's Hospital and Cardiovascular Institute, Guangdong, China
4 Fujian Provincial People's Hospital, Fujian, China
Correspondence to Dr. Jiang He, Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, 1430 Tulane Avenue SL18, New Orleans, LA 70112 (e-mail: jhe{at}tulane.edu) or Dr. Dongfeng Gu, Department of Evidence Based Medicine, Cardiovascular Institute and Fu Wai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, National Center for Cardiovascular Diseases, 167 Beilishi Road, Beijing, 100037, People's Republic of China (e-mail: gudf{at}yahoo.com).
Received for publication September 5, 2007. Accepted for publication December 12, 2007.
Chronic obstructive pulmonary disease mortality and risk factors were studied in a nationally representative sample of 169,871 Chinese men and women aged 40 years or older. Baseline data were collected in 1991 by using a standard protocol, and a follow-up evaluation was conducted in 1999–2000, with a response rate of 93.4%. Age-standardized mortality (per 100,000 person-years) was 179.9 for men and 141.3 for women. After adjustment for important covariables, the respective relative risks of chronic obstructive pulmonary disease–related mortality for baseline risk factors in men and women were 2.80 (95% confidence interval (CI): 2.64, 2.98) and 2.71 (95% CI: 2.53, 2.89) for each 10-year increase in age, 0.84 (95% CI: 0.74, 0.95) and 1.44 (95% CI: 1.07, 1.95) for alcohol consumption, 1.18 (95% CI: 1.04, 1.35) and 1.77 (95% CI: 1.45, 2.15) for 
20 pack-years of smoking, 2.37 (95% CI: 1.91, 2.94) and 2.47 (95% CI: 1.66, 3.67) for non-high-school graduation, 1.57 (95% CI: 1.38, 1.79) and 1.35 (95% CI: 1.17, 1.56) for physical inactivity, 2.66 (95% CI: 2.34, 3.02) and 2.60 (95% CI: 2.25, 3.00) for underweight, 1.39 (95% CI: 1.23, 1.57) and 1.73 (95% CI: 1.50, 2.00) for living in northern China, and 2.14 (95% CI: 1.86, 2.46) and 1.79 (95% CI: 1.55, 2.07) for living in rural China. This study indicated that cigarette smoking, low educational level, physical inactivity, and underweight are important modifiable risk factors for chronic obstructive pulmonary disease–related mortality in China.
China; mortality; prospective studies; pulmonary disease; chronic obstructive; risk factors
Abbreviations: CI, confidence interval; COPD, chronic obstructive pulmonary disease; ICD-9, International Classification of Diseases, Ninth Revision; RR, relative risk