Volume 182 - Issue 9

Impact of smoking, diabetes and hypertension on survival in the elderly: the Dubbo Study

Authors:  Leon A Simons and Judith Simons

Med J Aust 2005; 182 (9): 495-496. || doi: 10.5694/j.1326-5377.2005.tb06799.x
Published online: 2 May 2005

In reply: The prospective Dubbo Study of the elderly has produced a series of publications in which reduced peak expiratory flow (PEF) has been shown to be associated with increased risk of death,1,2 as well as increased risk of heart attack,3 ischaemic stroke4 and admission to a nursing home. 5 We have employed a purely statistical definition of impaired PEF, namely the lowest third of our sex-specific population distribution. We agree that many subjects so defined with impaired PEF, and who are smokers, will have underlying and potentially undiagnosed chronic obstructive pulmonary disease (COPD).

Epidemiological studies have highlighted the importance of impaired PEF. It is now time for health professionals to implement the COPDX management guidelines referred to by Frith6 in a still more effective manner and to devise better prevention programs.


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