Chest
Volume 134, Issue 2, August 2008, Pages 387-393
Journal home page for Chest

Original Research
Pulmonary Function Testing
FEV1 Response to Bronchodilation in an Adult Urban Population

https://doi.org/10.1378/chest.07-2207Get rights and content

Background

Most studies evaluating bronchodilation in flow-volume spirometry have been conducted in patients with obstructive airways diseases, but less is known about bronchodilation responses in the general population or in healthy subjects.

Methods

We evaluated an urban population sample of 628 adults (260 men, 368 women) aged 25 to 74 years with flow-volume spirometry using inhalation of 0.4 mg of a salbutamol aerosol with a spacer device for bronchodilation. On the basis of a structured interview, a subgroup of 219 healthy, asymptomatic nonsmokers was selected.

Results

In the population sample, the average increase in FEV1 from baseline after salbutamol inhalation was 77.2 mL (SD, 109.7 mL) or 2.5% (SD, 3.9%). In healthy asymptomatic nonsmokers, the mean change in FEV1 was 62.0 mL (SD, 89.7 mL) or 1.8% (SD, 2.6%). In the whole population, the 95th percentile limit of the increase in FEV1 was 8.5%, while it was 5.9% among healthy asymptomatic nonsmokers. The absolute change in FEV1 correlated significantly with baseline FVC (p < 0.01). The FEV1/FVC ratio at baseline was the strongest influencing factor for the bronchodilation response.

Conclusions

The results indicate that a significant increase in FEV1 from baseline in a bronchodilation test is around 9% in an urban population. The level of the significant absolute increase in FEV1 seems to depend on FVC. Low baseline FEV1/FVC ratio, reflecting airflow limitation, is the strongest determinant for FEV1 response to bronchodilation.

Section snippets

Subjects and Study Design

In 1995, a total of 8,000 adults aged 20 to 69 years were randomly sampled from the population of Helsinki, Finland, as a part of an epidemiologic multicenter questionnaire study on respiratory health in Finland, Estonia, and Sweden (or FinEsS study).20, 21, 22 The population sample was obtained from the Population Register Center, and was randomized by 10-year age cohorts and by gender. No exclusion criteria were applied. In the year 2000, a randomized sample of 1,200 subjects was selected

Population Sample

The absolute and relative changes in FEV1 after inhaling salbutamol with respect to the baseline spirometry values are shown in Figure 1. Both absolute and relative changes in FEV1 showed normal or a near-normal distribution within the population. For the population, the mean change in FEV1 was + 77.2 mL (95% CI, 68.6 to 85.8 mL) or 2.5% (95% CI, 2.2 to 2.8%); for men, the mean change in FEV1 was + 107.4 mL (95% CI, 91.4 to 123.3 mL) or 3.0% (95% CI, 2.5 to 3.5%); and for women, the mean change

Discussion

We have shown with flow-volume spirometry that baseline spirometry variables reflecting preexisting airflow limitation, age, and height are the most important determinants of bronchodilation response in an unselected random urban population. Also, in healthy asymptomatic nonsmokers preexisting airflow limitation was the strongest determinant. We found FEV1 to improve on average by 77.2 mL (or 2.5%) in the population sample and by 62.0 mL (or 1.8%) in healthy asymptomatic nonsmokers. A slight

Acknowledgment

The authors thank the personnel at the Research Unit of Pulmonary Diseases for excellent assistance.

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    This research was supported by a special governmental subsidy for health sciences research (Helsinki University Central Hospital project grant numbers TYH 1235, TYH 2303, and TYH 4251).

    The authors have reported to the ACCP that no significant conflicts of interest exist with any companies/organizations whose products or services may be discussed in this article.

    Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (www.chestjournal.org/misc/reprints.shtml).

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