Bronchodilator responsiveness and reported respiratory symptoms in an adult population.

PloS one

PubMedID: 23554960

Tan WC, Bourbeau J, Hernandez P, Chapman KR, Cowie R, FitzGerald JM, Aaron S, Marciniuk DD, Maltais F, Buist AS, O'Donnell DE, Sin DD, CanCOLD Collaborative Research Group. Bronchodilator responsiveness and reported respiratory symptoms in an adult population. PLoS ONE. 2013;8(3):e58932.
BACKGROUND
The relationship between patient-reported symptoms and objective measures of lung function is poorly understood.

AIM
To determine the association between responsiveness to bronchodilator and respiratory symptoms in random population samples.

METHODS
4669 people aged 40 years and older from 8 sites in Canada completed interviewer-administered respiratory questionnaires and performed spirometry before and after administration of 200 ug of inhaled salbutamol. The effect of anthropometric variables, smoking exposure and doctor-diagnosed asthma (DDA) on bronchodilator responsiveness in forced expiratory volume in 1 second (FEV1) and in forced vital capacity (FVC) were evaluated. Multiple logistic regression was used to test for association between quintiles of increasing changes in FEV1 and in FVC after bronchodilator and several respiratory symptoms.

RESULTS
Determinants of bronchodilator change in FEV1 and FVC included age, DDA, smoking, respiratory drug use and female gender [p<0.005 to p<0.0001 ]. In subjects without doctor-diagnosed asthma or COPD, bronchodilator response in FEV1 was associated with wheezing [p for trend<0.0001], while bronchodilator response for FVC was associated with breathlessness. [p for trend <0.0001].

CONCLUSIONS
Bronchodilator responsiveness in FEV1 or FVC are associated with different respiratory symptoms in the community. Both flow and volume bronchodilator responses are useful parameters which together can be predictive of both wheezing and breathlessness in the general population.