TY - JOUR
T1 - Impact of bronchodilator use on the prevalence of COPD in population-based samples
AU - Pérez-Padilla, Rogelio
AU - Hallal, Pedro Curi
AU - Vázquez-García, Juan Carlos
AU - Muiño, Adriana
AU - Máquez, María
AU - López, María Victorina
AU - De Oca, María Montes
AU - Tálamo, Carlos
AU - Valdivia, Gonzalo
AU - Pertuzé, Julio
AU - Jardim, Jose
AU - Menezes, Ana Maria B.
N1 - Funding Information:
Keywords: COPD definition, Diagnosis of COPD, Bronchodilator response, Airflow obstruction. The PLATINO group for this project was also formed by Luis Torre-Bouscoulet,1 Alexander Corcho-Berdugo,1 Francisco Franco-Marina,1 Cesar Victora,2 and Carmen Lisboa.5 Spirometry supervisors were: Fernanda W. Rosa, Aquiles Camelier, Oliver Nascimento, Elisa Sánchez-Gallén, Abigail Guzmán, Marcela Araya and Dolores Moreno. This study was proposed by ALAT (Asociación Latinoamericana del Tórax) and supported by a research grant from Boehringer-Ingelheim, but the company had no influence on the analysis or the manuscript writing. Correspondence to: Rogelio Pérez-Padilla Instituto Nacional de Enfermedades Respiratorias Tlalpan 4502, México DF 14080 email [email protected]
PY - 2007/4
Y1 - 2007/4
N2 - The aim of this study was to describe the impact of using bronchodilators on the prevalence of Chronic Obstructive Pulmonary Disease in a population-based survey (Platino study). A cluster sampling of subjects 40 years of age or older, representative of the metropolitan areas of 5 Latin American cities (Sao Paulo, Mexico, Montevideo, Santiago and Caracas) was chosen. Spirometry according to ATS standards was done before and after inhalation of 200 micrograms of salbutamol in 5183 subjects. Prevalences of airflow obstruction were estimated using different criteria, in tests done before and after bronchodilator use, and with reference values for pre- or post-bronchodilator use. Bronchodilator testing reduced the overall prevalence of FEV1/FVC% < 0.70 from 21.7% to 14% (35%). In the group with FEV1/FVC < 0.70 after bronchodilator use, 21% were asymptomatic from the respiratory point of view, and lacked significant adverse exposures. Subjects below the 5th percentile for FEV1/FVC and FEV1/FEV6 were fewer than those with FEV1/FVC < 0.70, especially among the elderly. More subjects are below the 5th percentile of FEV1/FVC and FEV1/FEV6 using reference values for tests after bronchodilator use than using the reference values determined without bronchodilator testing. Testing after bronchodilator use reduces the prevalence of airflow obstruction from 32 to 39% depending on the definition used. In addition, the subjects who were still obstructed after bronchodilator use were the ones who showed more respiratory symptoms and exposure to tobacco and other smokes and dusts, than subjects with reversible obstruction, suggesting an increased specificity for COPD.
AB - The aim of this study was to describe the impact of using bronchodilators on the prevalence of Chronic Obstructive Pulmonary Disease in a population-based survey (Platino study). A cluster sampling of subjects 40 years of age or older, representative of the metropolitan areas of 5 Latin American cities (Sao Paulo, Mexico, Montevideo, Santiago and Caracas) was chosen. Spirometry according to ATS standards was done before and after inhalation of 200 micrograms of salbutamol in 5183 subjects. Prevalences of airflow obstruction were estimated using different criteria, in tests done before and after bronchodilator use, and with reference values for pre- or post-bronchodilator use. Bronchodilator testing reduced the overall prevalence of FEV1/FVC% < 0.70 from 21.7% to 14% (35%). In the group with FEV1/FVC < 0.70 after bronchodilator use, 21% were asymptomatic from the respiratory point of view, and lacked significant adverse exposures. Subjects below the 5th percentile for FEV1/FVC and FEV1/FEV6 were fewer than those with FEV1/FVC < 0.70, especially among the elderly. More subjects are below the 5th percentile of FEV1/FVC and FEV1/FEV6 using reference values for tests after bronchodilator use than using the reference values determined without bronchodilator testing. Testing after bronchodilator use reduces the prevalence of airflow obstruction from 32 to 39% depending on the definition used. In addition, the subjects who were still obstructed after bronchodilator use were the ones who showed more respiratory symptoms and exposure to tobacco and other smokes and dusts, than subjects with reversible obstruction, suggesting an increased specificity for COPD.
KW - Airflow obstruction
KW - Bronchodilator response
KW - COPD definition
KW - Diagnosis of COPD
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U2 - 10.1080/15412550701341012
DO - 10.1080/15412550701341012
M3 - Article
C2 - 17530504
AN - SCOPUS:34547399133
SN - 1541-2555
VL - 4
SP - 113
EP - 120
JO - COPD: Journal of Chronic Obstructive Pulmonary Disease
JF - COPD: Journal of Chronic Obstructive Pulmonary Disease
IS - 2
ER -