Factors influencing the occurrence of airway hyperreactivity in the general population: the importance of atopy and airway calibre.

The factors that determine the occurrence of airway hyperreactivity in the general population are not clearly understood. This study was designed to assess the independent effects of age, atopy, smoking and airway calibre. In a random sample of 2,415 adults aged 18-70 yrs we measured reactivity to methacholine as the dose provoking a 20% fall (PD20) in one-second forced expiratory volume (FEV1), atopy as the mean skin wheal response to three common environmental allergens, and airway calibre as the baseline FEV1 in absolute terms, as percent predicted (FEV1 % predicted) and as percent forced vital capacity (FEV1 % FVC). Hyperreactivity, defined as a PD20 < or = 12.25 mumol, was present in 314 (13%) of the sample, and before adjustment for FEV1 was more common in females (independent odds ratio (OR) = 2.05 (95% confidence interval 1.6-2.7)), current smokers (OR = 1.89 (1.3-2.6)), atopics (OR = 1.39 (1.3-1.5) per mm skin wheal), and in older age groups (OR for age 60-70 yrs relative to 18-29 yrs = 2.70 (1.7-4.3)). However, the odds of hyperreactivity were also strongly and independently related to absolute FEV1 (OR = 0.46 (0.27-0.77) per litre), FEV1 % predicted (OR = 0.96 (0.94-0.98) per percent), and FEV1 % FVC (OR = 0.92 (0.90-0.94) per percent; combined chi-square on 3 df = 312, p << 0.0001).(ABSTRACT TRUNCATED AT 250 WORDS)

[1]  P. Burney,et al.  Factors affecting peak expiratory flow variability and bronchial reactivity in a random population sample. , 1993, Thorax.

[2]  G. Gibson.  Standardised lung function testing. , 1993, The European respiratory journal.

[3]  A. Coulson,et al.  Effects of smoked substance abuse on nonspecific airway hyperresponsiveness. , 1993, The American review of respiratory disease.

[4]  C. Ulrik.  Bronchial responsiveness to inhaled histamine in both adults with intrinsic and extrinsic asthma: the importance of prechallenge forced expiratory volume in 1 second. , 1993, The Journal of allergy and clinical immunology.

[5]  C. Salome,et al.  Relation of dose-response slope to respiratory symptoms and lung function in a population study of adults living in Busselton, Western Australia. , 1992, The American review of respiratory disease.

[6]  M. Sears,et al.  Relationships of bronchial responsiveness assessed by methacholine to serum IgE, lung function, symptoms, and diagnoses in 11-year-old New Zealand children. , 1992, The Journal of allergy and clinical immunology.

[7]  A. Dirksen,et al.  Airway calibre as a confounder in interpreting bronchial responsiveness in asthma. , 1992, Thorax.

[8]  E. Bleecker,et al.  The Lung Health Study: Airway Responsiveness to Inhaled Methacholine in Smokers with Mild to Moderate Airflow Limitation , 1992 .

[9]  F. Neukirch,et al.  Peak Expiratory Flow Variability and Bronchial Responsiveness to Methacholine , 1992 .

[10]  J. Britton.  Airway hyperresponsiveness and the clinical diagnosis of asthma: histamine or history? , 1992, The Journal of allergy and clinical immunology.

[11]  M. Sears,et al.  Relation between airway responsiveness and serum IgE in children with asthma and in apparently normal children. , 1991, The New England journal of medicine.

[12]  E. M. Laursen,et al.  The distribution of bronchial responsiveness to histamine and exercise in 527 children and adolescents. , 1991, The Journal of allergy and clinical immunology.

[13]  A. Gulsvik,et al.  Bronchial responsiveness in a Norwegian community. , 1991, The American review of respiratory disease.

[14]  M. Segal,et al.  The Influence of Age and Level of Pulmonary Function on Nonspecific Airway Responsiveness , 1991 .

[15]  R. Tepper,et al.  Changes in airway reactivity with age in normal infants and young children. , 1990, The American review of respiratory disease.

[16]  B. Sibbald,et al.  A general practice based survey of bronchial hyperresponsiveness and its relation to symptoms, sex, age, atopy, and smoking. , 1990, Thorax.

[17]  E. Mitchell,et al.  The interrelationship among bronchial hyperresponsiveness, the diagnosis of asthma, and asthma symptoms. , 1990, The American review of respiratory disease.

[18]  J. Crane,et al.  The relationships between atopy, bronchial hyperresponsiveness, and a family history of asthma: a cross-sectional study of migrant Tokelauan children in New Zealand. , 1989, The Journal of allergy and clinical immunology.

[19]  M. Lebowitz,et al.  Smoking habit and bronchial reactivity in normal subjects. A population-based study. , 1989, The American review of respiratory disease.

[20]  R. Dales,et al.  Relation of airway responsiveness to duration of work in a dusty environment. , 1989, Thorax.

[21]  P. Lesouëf,et al.  Response of normal infants to inhaled histamine. , 1989, The American review of respiratory disease.

[22]  A. Tattersfield,et al.  Dose related effects of salbutamol and ipratropium bromide on airway calibre and reactivity in subjects with asthma. , 1988, Thorax.

[23]  S. Vedal,et al.  Asthma, asthmalike symptoms, chronic bronchitis, and the degree of bronchial hyperresponsiveness in epidemiologic surveys. , 1987, The American review of respiratory disease.

[24]  F. Speizer,et al.  The association of airways responsiveness to respiratory symptom prevalence and to pulmonary function in a random population sample. , 1987, Bulletin europeen de physiopathologie respiratoire.

[25]  F. Speizer,et al.  The relationship of nonspecific bronchial responsiveness to respiratory symptoms in a random population sample. , 1987, The American review of respiratory disease.

[26]  G. O'Connor,et al.  The relationship of nonspecific bronchial responsiveness to the occurrence of respiratory symptoms and decreased levels of pulmonary function. The Normative Aging Study. , 1987, The American review of respiratory disease.

[27]  S. Anderson,et al.  Prevalence of bronchial hyperresponsiveness and asthma in a rural adult population. , 1987, Thorax.

[28]  P. Burney,et al.  Descriptive epidemiology of bronchial reactivity in an adult population: results from a community study. , 1987, Thorax.

[29]  R. Roberts,et al.  Differences in responsiveness to hyperventilation and methacholine in asthma and chronic bronchitis. , 1985, Thorax.

[30]  A. Woolcock,et al.  Rapid method for measurement of bronchial responsiveness. , 1983, Thorax.

[31]  D. Cockcroft,et al.  Bronchial response to inhaled histamine in asymptomatic young smokers. , 1983, European journal of respiratory diseases.

[32]  J. Ramsdell,et al.  Bronchial hyperreactivity in chronic obstructive bronchitis. , 2015, The American review of respiratory disease.

[33]  E. Walters,et al.  Measurement of bronchial reactivity: a question of interpretation. , 1981, Thorax.