Vestbo, J.; Hansen, E. F.
September 2001
Thorax;Sep2001 Supp, Vol. 56, pii11
Academic Journal
Background: Smoking and airway lability which is expressed by histamine airway hyperresponsiveness, are known risk factors for development of respiratory symptoms. Smoking is also associated with increased mortality risks. We studied whether airway hyperresponsiveness is associated with increased mortality and whether this risk was independent of smoking and reduced lung function. Methods: We followed up 2008 inhabitants of the communities of Vlagtwedde, Vlaardingen, and Meppel (Netherlands), who had histamine challenge test data from 1964-72 for 30 years. Follow-up was 99% successful (29 patients lost to follow-up) with 1453 participants alive and 526 deaths (246 died from cardiovascular disease, 54 from lung cancer, and 21 from chronic obstructive pulmonary disease (COPD)). Findings: Mortality from COPD increased with more severe hyper-responsiveness relative risks of 3.83 (95% Cl 0.97-15.1), 4.40 (1.16-16.7), 4.78 1.27-18.0), 6.69 (1.71-26.1), and 15.8 (3.72-67.1) were associated with histamine thresholds of 32 g/l, 16 g/l, 8 g/l, 4 g/I, and 1 g/l, respectively compared with no hyperresponsiveness. These risks were adjusted for sex, age, smoking, lung function, body mass index, positive skin tests, eosinophilia, asthma, and city of residence. Interpretation: Increased histamine airway hyper-responsiveness predicts modality from COPD. Although this trend was more pronounced in smokers, an increasing proportion of COPD deaths with increasing hyper-responsiveness was also present among individuals who had never smoked.


Related Articles

  • Authors' reply to 'Explaining differential effects of tiotropium on mortality in COPD'. Jenkins, Christine; Beasley, Richard // Thorax;Jun2013, Vol. 68 Issue 6, p590 

    A response from the author of an article related to effects of tiotropium on mortality in chronic obstructive pulmonary disease (COPD) is presented.

  • State-Specific Smoking-Attributable Chronic Obstructive Pulmonary Disease Mortality—United States, 1986.  // JAMA: Journal of the American Medical Association;9/8/89, Vol. 262 Issue 10, p1303 

    Examines the mortality figures caused by smoking-attributable to chronic obstructive pulmonary disease (SA-COPD) in the United States in 1986. Observation of the state and regional differences; Analysis of state specific smoking prevalence rates, quit-ratios, and age-adjusted SA-COPD mortality...

  • The impact of asthma and COPD in sub-Saharan Africa. Gemerta, Frederik van; der Molena, Thys van; Jonesb, Rupert; Chavannes, Niels // Primary Care Respiratory Journal;Sep2011, Vol. 20 Issue 3, p240 

    Background: Many countries in sub-Saharan Africa have the highest risk of developing chronic diseases and are the least able to cope with them. Aims: To assess the current knowledge of the prevalence and impact of asthma and chronic obstructive pulmonary disease (COPD) in sub-Saharan Africa....

  • GPs told to up steroids in asthmatic smokers.  // New Zealand Doctor;9/12/2007, p25 

    The article focuses on the guidelines issued by the Scottish Intercollegiate Guidelines Network and the British Thoracic Society regarding the pharmacological management of asthma. The guidance recommends the administration of higher-than-usual doses of inhaled steroids to patients with asthma...

  • Diagnosis of Chronic Obstructive Pulmonary Disease. Stephens, Mark B.; Yew, Kenneth S. // American Family Physician;7/1/2008, Vol. 78 Issue 1, p87 

    Chronic obstructive pulmonary disease affects more than 26 million adults in the United States. Family physicians provide care for most of these patients. Cigarette smoking is the leading risk factor for chronic obstructive pulmonary disease, although other risk factors, including occupational...

  • Identifying Students with Self-Report of Asthma and Respiratory Symptoms in an Urban, High School Setting. Christine Joseph; Alan Baptist; Sonja Stringer; Suzanne Havstad; Dennis Ownby; Christine Johnson; L. Williams; Edward Peterson // Journal of Urban Health;Jan2007, Vol. 84 Issue 1, p60 

    Abstract??Strategies for identifying urban youth with asthma have not been described for high school settings. African-American high school students are rarely included in asthma studies, despite a high risk of asthma mortality when compared to other age and race groups. Identification and...

  • Asthma in an Urban Population in Portugal: A prevalence study. Sousa, Jaime Correia de; Santo, Maria Espírito; Colaço, Tânia; Almada-Lobo, Filipa; Yaphe, John // BMC Public Health;2011 Supplement 4, Vol. 11 Issue Suppl 4, p347 

    Background: The prevalence and incidence of asthma are believed to be increasing but research on the true incidence, prevalence and mortality from asthma has met methodological obstacles since it has been difficult to define and diagnose asthma in epidemiological terms. New and widely accepted...

  • Educational Inequalities in Three Smoking-Related Causes of Death in 18 European Populations. Kulik, Margarete C.; Menvielle, Gwenn; Eikemo, Terje A.; Bopp, Matthias; Jasilionis, Domantas; Kulhánová, Ivana; Leinsalu, Mall; Martikainen, Pekka; Östergren, Olof; Mackenbach, Johan P. // Nicotine & Tobacco Research;May2014, Vol. 16 Issue 5, p507 

    Introduction: Smoking is an important determinant of socioeconomic inequalities in mortality in many countries. As the smoking epidemic progresses, updates on the development of mortality inequalities attributable to smoking are needed. We provide estimates of relative and absolute educational...

  • COPD increased in women from 2000 to 2005.  // Hem/Onc Today;12/25/2008, Vol. 9 Issue 23, p56 

    The article focuses on the results from data from the National Vital Statistics System which estimate that one in 20 U.S. deaths in 2005 had chronic obstructive pulmonary disorder as an underlying cause. It states that cigarette smoking is estimated to be responsible for nearly 75 percent of all...


Read the Article


Sign out of this library

Other Topics