Habitual coughing and its associations with asthma, anxiety, and gastroesophageal reflux.

STUDY OBJECTIVE Coughing was studied in relation to different disorders and objective variables indicative of airway inflammation. SETTING A random sample of 800 persons, aged 20 to 44 years, was chosen from a larger cohort of participants in the European Community Respiratory Health Survey in Uppsala Sweden; of these, 623 participated. This sample was enriched with 201 individuals who reported asthma-related symptoms or the use of asthma medication. METHODS The study comprised a structured interview, including questions about habitual (productive and nonproductive) and nocturnal coughing and spirometry, methacholine challenge, peak flow diary, skin prick tests, and measurements of blood eosinophil count and serum eosinophil cationic protein (S-ECP). RESULTS A significant positive correlation was found between productive coughing and asthma (adjusted odds ratios [OR] = 2.0), allergic rhinitis (OR = 1.9), gastroesophageal reflux (OR = 4.4), smoking (OR = 1.9), and anxiety (OR = 1.8), while nonproductive coughing was related to female gender (OR = 1.8) and anxiety (OR = 1.7). Nocturnal coughing was positively correlated to female gender (OR = 1.8), smoking (OR = 1.9), and asthma (OR = 2.2). Bronchial hyperresponsiveness was positively related to productive coughing (p < 0.001), nonproductive coughing, and nocturnal coughing (p < 0.05). S-ECP was significantly higher in individuals with nonproductive coughing compared with subjects without habitual coughing (p < 0.01). CONCLUSIONS We conclude that habitual coughing has a significant association with different disease categories.

[1]  T. Gislason,et al.  Daytime sleepiness, snoring and gastro‐oesophageal reflux amongst young adults in three European countries , 1995, Journal of internal medicine.

[2]  C. Janson,et al.  Symptoms related to asthma and chronic bronchitis in three areas of Sweden. , 1994, The European respiratory journal.

[3]  C. Janson,et al.  Serum eosinophil cationic protein in relation to bronchial asthma in a young Swedish population , 1994, Allergy.

[4]  C. Janson,et al.  Anxiety and depression in relation to respiratory symptoms and asthma. , 1994, American journal of respiratory and critical care medicine.

[5]  P. Venge,et al.  Soluble markers of allergic inflammation , 1994, Allergy.

[6]  D. Jarvis,et al.  The European Community Respiratory Health Survey. , 1994, The European respiratory journal.

[7]  A. Ing,et al.  Pathogenesis of chronic persistent cough associated with gastroesophageal reflux. , 1994, American journal of respiratory and critical care medicine.

[8]  R. Irwin,et al.  Chronic cough due to gastroesophageal reflux. Clinical, diagnostic, and pathogenetic aspects. , 1993, Chest.

[9]  A P Smith,et al.  Voluntary cough suppression as an indication of symptom severity in upper respiratory tract infections. , 1993, The European respiratory journal.

[10]  K. Min,et al.  Cough variant asthma is associated with a higher wheezing threshold than classic asthma , 1993, Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology.

[11]  R B D'Agostino,et al.  The health risks of smoking. The Framingham Study: 34 years of follow-up. , 1993, Annals of epidemiology.

[12]  P. Venge Serum measurements of eosinophil cationic protein (ECP) in bronchial asthma , 1993, Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology.

[13]  I. Chapman,et al.  The relationship between inflammation and hyperreactivity of the airways in asthma , 1993, Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology.

[14]  I. Räihä,et al.  Prevalence and Characteristics of Symptomatic Gastroesophageal Reflux Disease in the Elderly , 1992, Journal of the American Geriatrics Society.

[15]  R. Pierce,et al.  Chronic persistent cough: use of ipratropium bromide in undiagnosed cases following upper respiratory tract infection. , 1992, Respiratory medicine.

[16]  W. Hall,et al.  Cough and Angioneurotic Edema Associated with Angiotensin-Converting Enzyme Inhibitor Therapy , 1992, Annals of Internal Medicine.

[17]  P. Cullinan,et al.  Persistent cough and sputum: prevalence and clinical characteristics in south east England. , 1992, Respiratory medicine.

[18]  P. Burney,et al.  Comparison of bronchial reactivity and peak expiratory flow variability measurements for epidemiologic studies. , 1992, The American review of respiratory disease.

[19]  M. Fujimura,et al.  Cough receptor sensitivity and bronchial responsiveness in normal and asthmatic subjects. , 1992, The European respiratory journal.

[20]  J. Samet Health benefits of smoking cessation. , 1991, Clinics in chest medicine.

[21]  W. Busse,et al.  Immediate and late airway response of allergic rhinitis patients to segmental antigen challenge. Characterization of eosinophil and mast cell mediators. , 1991, The American review of respiratory disease.

[22]  G. O'Connor,et al.  Asthma, hay fever, and phlegm production associated with distinct patterns of allergy skin test reactivity, eosinophilia, and serum IgE levels. The Normative Aging Study. , 1991, The American review of respiratory disease.

[23]  O'Connell Ej,et al.  Cough-type asthma: a review. , 1991 .

[24]  A. Tattersfield,et al.  A comparison of the Yan and a dosimeter method for methacholine challenge in experienced and inexperienced subjects. , 1991, The European respiratory journal.

[25]  M. Halonen,et al.  A longitudinal study of respiratory symptoms in a community population sample. Correlations with smoking, allergen skin-test reactivity, and serum IgE. , 1991, Chest.

[26]  J. Bousquet,et al.  Eosinophilic inflammation in asthma. , 1990, The New England journal of medicine.

[27]  R. Irwin,et al.  Chronic cough. The spectrum and frequency of causes, key components of the diagnostic evaluation, and outcome of specific therapy. , 1990, The American review of respiratory disease.

[28]  N Poisson,et al.  Validity and repeatability of the IUATLD (1984) Bronchial Symptoms Questionnaire: an international comparison. , 1989, The European respiratory journal.

[29]  J. Denburg,et al.  CHRONIC COUGH: EOSINOPHILIC BRONCHITIS WITHOUT ASTHMA , 1989, The Lancet.

[30]  L. Poulsen,et al.  Immunochemical estimations of allergenic activities from outdoor aero‐allergens, collected by a high‐volume air sampler , 1989, Allergy.

[31]  J. Widdicombe,et al.  Afferent neural pathways in cough and reflex bronchoconstriction. , 1988, Journal of applied physiology.

[32]  R. Peto REPRESENTATION OF THE PEOPLE? , 1988, The Lancet.

[33]  R. Snaith,et al.  The Hospital Anxiety And Depression Scale , 2003, Health and quality of life outcomes.

[34]  N. Choudry,et al.  Increased cough reflex associated with angiotensin converting enzyme inhibitor cough. , 1987, British medical journal.

[35]  P. Burney,et al.  Developing a new questionnaire for measuring the prevalence and distribution of asthma. , 1987, Chest.

[36]  S. Braman,et al.  Chronic cough as the sole presenting manifestation of bronchial asthma. , 1979, The New England journal of medicine.

[37]  G. Settipane,et al.  Risk factors for developing asthma and allergic rhinitis. A 7-year follow-up study of college students. , 1976, The Journal of allergy and clinical immunology.