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October 22, 1998New England Journal of Medicine1,256 citations

A 15-Year Follow-up Study of Ventilatory Function in Adults with Asthma

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PLPeter LangeJPJan ParnerJVJørgen Vestbo

Key Points

  • To determine the 15-year natural history and rate of ventilatory function decline in adults with self-reported asthma compared to non-asthmatic adults.
  • Longitudinal population study analyzing 17,506 Danish adults (8,136 men and 9,370 women; 1,095 with asthma) from the Copenhagen City Heart Study between 1976 and 1994.
  • Obtained three sequential measurements of forced expiratory volume in one second (FEV1) per subject across a 15-year follow-up period.
  • Unadjusted annual FEV1 decline was 38 ml/year in adults with asthma compared to 22 ml/year in those without asthma, representing a significantly greater height-normalized rate of loss (P<0.001).
  • Accelerated FEV1 decline remained consistent across both sexes and among smokers and nonsmokers alike (P<0.001 for all comparisons).
  • At age 60, a 175-cm nonsmoking man without asthma averaged an FEV1 of 3.05 liters versus 1.99 liters for a smoking man of identical age and height with asthma.

Abstract

BACKGROUND: Although the prevalence of asthma and morbidity related to asthma are increasing, little is known about the natural history of lung function in adults with this disease. METHODS: We used data from a longitudinal epidemiologic study of the general population in a Danish city, the Copenhagen City Heart Study, to analyze changes over time in the forced expiratory volume in one second (FEV1) in adults with self-reported asthma and adults without asthma. The study was conducted between 1976 and 1994; for each patient, three measurements of lung function were obtained over a 15-year period. The final data set consisted of measurements from 17,506 subjects (8136 men and 9370 women), of whom 1095 had asthma. RESULTS: Among subjects who participated in all three evaluations, the unadjusted decline in FEV1 among subjects with asthma was 38 ml per year, as compared with 22 ml per year in those without asthma. The decline in FEV1 normalized for height (FEV1 divided by the square of the height in meters) was greater among the subjects with asthma than among those without the disease (P<0.001). Among both men and women, and among both smokers and nonsmokers, subjects with asthma had greater declines in FEV1 over time than those without asthma (P<0.001). At the age of 60 years, a 175-cm-tall nonsmoking man without asthma had an average FEV1 of 3.05 liters, as compared with 1.99 liters for a man of similar age and height who smoked and had asthma. CONCLUSIONS: In a sample of the general population, people who identified themselves as having asthma had substantially greater declines in FEV1 over time than those who did not.

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Cite This Study

Lange et al. (1998) studied this question.

synapsesocial.com/papers/6a1046e62badbc352affb0b7https://doi.org/10.1056/nejm199810223391703
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