Defining Impaired Respiratory Health. A Paradigm Shift for Pulmonary Medicine

Respiratory research has historically focused on identifying risk factors for and treatment of established lung disease. Public health approaches to common conditions, however, mandate that health promotion is a central feature of disease prevention. While smoking initiation prevention and cessation efforts are essential to respiratory health promotion, there are far fewer accepted strategies of preventative care in respiratory medicine compared with cardiovascular medicine. A key reason for this is the absence of a comprehensive body of research guiding the assessment of risk for respiratory disease as has been established for cardiovascular disease. Recent evidence provides insight into how the respiratory community can shift research priorities towards developing a definition of respiratory health spanning ideal health, impaired health, and disease. Central to defining respiratory health are the dual concepts of pulmonary reserve as reflected by peak respiratory health in young adulthood and susceptibi...