International trends in asthma mortality

Area of Science:

• Pulmonology
• Epidemiology
• Pharmacology

Background:

• Asthma mortality patterns have varied significantly throughout the 20th century.
• A notable trend includes a gradual increase in asthma mortality over the last 50 years across many nations.
• Sudden, marked increases in asthma mortality were observed in several countries during the 1960s and 1970s.

Purpose of the Study:

• To analyze historical trends in asthma mortality.
• To investigate potential causes for observed increases and decreases in asthma mortality.
• To identify factors contributing to asthma mortality epidemics.

Main Methods:

• Review of historical asthma mortality data from various countries.
• Analysis of potential contributing factors such as asthma prevalence, environmental triggers, and management strategies.
• Examination of drug usage patterns, specifically high-dose beta-agonist preparations.

Main Results:

• Asthma mortality rates remained stable in the first half of the 20th century, then gradually increased.
• High-dose preparations of isoprenaline forte and fenoterol were identified as the cause of mortality 'epidemics' in the 1960s and 1970s.
• Recent decades show a reduction in asthma mortality in some western countries, possibly linked to improved asthma management.

Conclusions:

• The use of specific high-dose beta-agonist drugs significantly impacted asthma mortality trends.
• Improvements in asthma management may be contributing to the recent decline in mortality rates.
• Understanding the complex interplay of prevalence, triggers, and treatment is crucial for public health strategies.