Chest
Original ResearchPulmonary Function TestingFEV1 Response to Bronchodilation in an Adult Urban Population
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.
References (29)
- et al.
Bronchodilator reversibility testing in an adult general population: the importance of smoking and anthropometrical variables on the response to a β2-agonist
Pulm Pharm Ther
(2006) Tests of forced expiration and inspiration
Clin Chest Med
(2001)- et al.
Smoking, respiratory symptoms, and diseases: a comparative study between northern Sweden and northern Finland: report from the FinEsS study
Chest
(2001) - et al.
Asthma, chronic bronchitis and respiratory symptoms among adults in Estonia according to a postal questionnaire
Respir Med
(2001) - et al.
Analysing bronchodilation with emphasis on disease type, age and sex
Control Clin Trials
(2004) - et al.
Spirometric tests to diagnose suspected asthma
Am Rev Respir Dis
(1969) - et al.
Interpretative strategies for lung function tests
Eur Respir J
(2005) Lung function testing: selection of reference values and interpretative strategies
Am Rev Respir Dis
(1991)Standardisation of spirometry: 1994 update
Am J Respir Crit Care Med
(1995)- et al.
Lung volumes and forced ventilatory flows: report Working Party Standardization of Lung Function Tests, European Community for Steel and Coal; official statement of the European Respiratory Society
Eur Respir J Suppl
(1993)
Short term variability in FEV1 and bronchodilator responsiveness in patients with obstructive ventilatory defects
Thorax
A comparison of six different ways of expressing the bronchodilating response in asthma and COPD: reproducibility and dependence of prebronchodilator FEV1
Eur Respir J
Interpretation of bronchodilator response in patients with obstructive airways disease: the Dutch Chronic Non-Specific Lung Disease (CNSLD) Study Group
Thorax
Bronchodilator reversibility testing in chronic obstructive pulmonary disease
Thorax
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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).