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Published on: February 9, 2022
Bronchodilator response to adrenergic beta2-agonists: relationship to symptoms in an adult community
Sverre Lehmann1, Per Sigvald Bakke, Geir Egil Eide
1Section for Thoracic Medicine, Institute of Medicine, University of Bergen, 5021 Bergen, Norway. sverre.lehmann@helse-bergen.no
Background:
Wheeze and chest tightness has traditionally been associated with enhanced bronchial responsiveness. However, no community studies are available on the associations between bronchodilator response and respiratory symptoms among adults.
Aim:
To examine how respiratory symptoms predict bronchodilator response.
Methods:
An age and gender stratified random sample of all adults aged 47-48 and 71-73 years in Bergen, Norway, were invited. The 3506 participants (69%) filled in questionnaires including nine symptoms and performed bronchodilator reversibility tests. Subjects without current anti-asthmatic medication performing acceptable reversibility tests were included in the analyses (n=3088).
Results:
A reversibility with FEV(1) increase 12% and 200 ml was obtained in 2% of middle-aged and 4% of elderly subjects (p=0.001). In multiple linear regression analysis bronchodilatation was positively associated with wheezing without cold (FEV(1) increase of 1.5%, 95% CI: (0.9, 2.2)% in all participants and 31 ml, 95% CI: (1, 61)ml in men only) and dyspnoea climbing two flights of stairs (0.9%, 95% CI: (0.5,1.4)% and 12 ml, 95% CI: (1,23)ml). Chronic cough predicted the response negatively (-0.7%, 95% CI: (-1.3,-0.1)% and -17 ml, 95% CI: (-32,-2)ml). In multiple logistic regression analysis morning cough predicted an FEV(1) increase 12% and 200 ml (OR: 1.8, 95% CI: (1.1,2.8)).
Conclusions:
A small fraction of adults in a general population has bronchodilatation after salbutamol inhalation. "Wheezing without cold", "dyspnoea climbing two flights of stairs", and "morning cough" predict an increased bronchodilator response among subjects without current anti-asthmatic medications.
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