Risk factors for ventilatory impairment among middle-aged and elderly men. The Normative Aging Study

To evaluate the relationship of atopy and inflammation to the occurrence of ventilatory impairment, we studied 1,301 middle-aged and older men participating in the Normative Aging Study at the time of their 1984 to 1987 examination. Screening at entry to the study in the 1960s had excluded subjects with asthma and other chronic diseases at that time. After adjustment for smoking status and pack-years in this cross-sectional analysis, a weak inverse relationship between FEV1 and blood eosinophil count was not statistically significant, and FEV1 showed no relationship to blood eosinophil count as a percentage of total leukocytes. A weak inverse relationship between FEV1 and serum total IgE concentration was not statistically significant. Cutaneous immediate hypersensitivity to one or more common aeroallergens was not related to FEV1. A significant inverse relationship between FEV1 and blood total leukocyte count was observed in never and former smokers. FEV1 was significantly lower in subjects reporting usual phlegm production. These findings suggest that ventilatory impairment is not related to atopic status among middle-aged and older men without a history of asthma. The inverse relationship between total leukocyte count and FEV1 in this sample supports the hypothesis that nonallergic inflammation plays a role in the pathogenesis of chronic airflow obstruction in this group.