Respiratory symptoms in preserved ratio impaired spirometry: Link to comorbidities and increased mortality risk

Respiratory symptoms are frequently observed in subjects with Preserved Ratio Impaired Spirometry (PRISm); however, their association with comorbidities and mortality in this population remains poorly understood.

Data from the National Health and Nutrition Examination Survey (2007-2012) were analyzed. Logistic regression was used to assess the association between respiratory symptoms and comorbidities, while Cox regression was applied to evaluate mortality risks.

This study included 5612 adults aged 40 years and older with normal spirometry and 754 participants with PRISm. Among the PRISm group, 331 subjects (43.8 %) reported one or more respiratory symptoms. Compared to individuals with normal spirometry, PRISm subjects with respiratory symptoms exhibited a significantly higher prevalence of comorbidities, including hypertension, diabetes, angina, myocardial infarction, heart failure, and stroke, as well as increased risks of all-cause and cardiovascular mortality. In contrast, PRISm without respiratory symptoms was primarily associated with diabetes and an elevated mortality risk. When comparing PRISm subjects with and without respiratory symptoms, those with symptoms had a markedly higher prevalence of hypertension (OR 1.10, 95 % CI: 1.08-1.11), myocardial infarction (OR 5.75, 95 % CI: 2.25-14.67), heart failure (OR 5.52, 95 % CI: 2.50-12.19), and cancer (OR 2.34, 95 % CI: 1.12-4.86). Additionally, PRISm subjects with respiratory symptoms faced a significantly elevated risk of cardiovascular mortality (HR 1.55, 95 % CI: 1.38-1.74).

Respiratory symptoms were associated with a significantly higher burden of comorbidities and an increased risk of cardiovascular mortality in PRISm subjects.