From Lungs to Vascular Health: Airflow Obstruction, Not Lung Function Decline, Predicts Atherosclerosis Progression Independent of Smoking Status

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dc.contributor.authorHenríquez-Beltrán, Mario
dc.contributor.authorGracia-Lavedan, Esther
dc.contributor.authorSánchez-Cucó, Anna
dc.contributor.authorTorres, Gerard
dc.contributor.authorTarga, Adriano D. S.
dc.contributor.authorBermúdez López, Marcelino
dc.contributor.authorValdivielso, José Manuel
dc.contributor.authorPamplona Gras, Reinald
dc.contributor.authorMauricio, Dídac
dc.contributor.authorCastro-Boqué, Eva
dc.contributor.authorFernández, Elvira
dc.contributor.authorLecube, Albert
dc.contributor.authorde Batlle, Jordi
dc.contributor.authorBarbé Illa, Ferran
dc.contributor.authorGonzález, Jessica
dc.date.accessioned2026-07-24T07:01:57Z
dc.date.available2026-07-24T07:01:57Z
dc.date.issued2026
dc.description.abstractObjectives: To prospectively evaluate the relationship between 4-year changes in lung function and the progression of subclinical atherosclerosis among 1623 middle-aged adults with at least one cardiovascular risk factor participating in ILERVAS, and to determine whether individuals who develop airflow obstruction (AO) are especially susceptible to accelerated atherosclerosis progression. Methods: This prospective cohort study included 1623 middle-aged adults from the ILERVAS cohort, recruited in primary care centers in the province of Lleida (Catalonia, Spain), with baseline assessments conducted between 2015 and 2018 and follow-up visits between 2019 and 2021 (mean follow-up, 3.99 [SD, 0.22] years). Pulmonary function was assessed by spirometry at baseline and at 4-year follow-up. Subclinical atherosclerosis was evaluated using vascular ultrasound of 12 carotid and femoral territories at baseline and at follow-up, with total plaque area quantified. Associations were analyzed using multivariable linear regression models, adjusting for clinical variables and baseline plaque burden. Analyses were stratified by smoking status. Results: Median annual declines were -95mL (-2.04%) for FVC and -78mL (-2.00%) for FEV1. Categorization of annual pulmonary function decline by tertiles showed no significant association with plaque progression. In contrast, incident AO was associated with greater annual FEV1 decline (-146.73 vs -74.90mL; P<.001) and with greater plaque burden, reflected by an increase in affected vascular territories (0.26 [IQR, 0.00-0.75]; P<.001). Multivariable models confirmed larger annual increases in total (4.40mm2; P<.001), carotid (2.33mm2; P<.001), and femoral (1.99mm2; P=.031) plaque areas among participants with incident AO, with consistent results across smoking strata. Sensitivity analyses using a lower limit of normal-based definition of AO showed similar findings, with effect estimates consistent with the primary fixed-ratio analyses. Conclusions: In this two-time-point analysis, lung function decline was not independently associated with subclinical atherosclerosis progression. In contrast, incident AO was consistently associated with greater plaque progression across smoking strata. These findings support incident AO as a spirometric marker associated with vascular risk.
dc.identifier.doihttps://doi.org/10.1016/j.arbres.2026.04.012
dc.identifier.issn1579-2129
dc.identifier.issn0300-2896
dc.identifier.urihttps://hdl.handle.net/10459.1/470982
dc.language.isoen
dc.language.isospa
dc.publisherElsevier
dc.relation.isformatofReproducció del document publicat a: https://doi.org/10.1016/j.arbres.2026.04.012
dc.relation.ispartofArchivos de Bronconeumologia, 26026, vol. 26 [Epub ahead of print]
dc.rightscc-by (c)The Authors, 2026
dc.rightsAttribution 4.0 International*
dc.rights.accessRightsinfo:eu-repo/semantics/openAccess
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/*
dc.subjectAirflow obstruction
dc.subjectAtherosclerosis
dc.subjectPulmonary function
dc.titleFrom Lungs to Vascular Health: Airflow Obstruction, Not Lung Function Decline, Predicts Atherosclerosis Progression Independent of Smoking Status
dc.typeinfo:eu-repo/semantics/article
dc.type.versioninfo:eu-repo/semantics/publishedVersion
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