Decline in Lung Function in the Busselton Health Study

Abstract

Asthma in adults may be associated with chronic airflow obstruction, possibly resulting from airway disease in early life and/or a greater rate of decline in lung function in adult life compared with those with asthma. Treatment and cigarette smoking may also influence the rate of decline of lung function. The aim of this analysis was to examine the level and rate of decline in lung function in relationship to asthma and cigarette smoking in adults. Subjects (n = 9,317) had participated as adults (> 18 years) in one or more of the cross-sectional Busselton Health Surveys between 1966 and 1981 or in the follow-up study of 1994/1995. The effects of sex, doctor-diagnosed asthma, smoking status, and anthropometric data on the level and rate of decline in FEV1 were examined in a linear mixed effects model. At the age of 19 years, FEV1 was reduced in subjects with asthma but was similar in smokers and nonsmokers. Males, taller subjects, smokers, and subjects with asthma had greater declines in FEV1 with age. Smoking and asthma had additive but not multiplicative effects on decline. Thus, asthma is associated with reduced lung function at the beginning of adult life as well as an increased rate of decline during adult life.

The association of common genetic variants in the APOA5, LPL and GCK genes with longitudinal changes in metabolic and cardiovascular traits

“…Participants The BHS includes a series of seven crosssectional population health surveys of adult residents of the Shire of Busselton in the south-west of Western Australia, undertaken between 1966 and 1990, and focused on respiratory and cardiovascular phenotypes [23][24][25]. In 1994/1995 a cross-sectional community follow-up study, which included the collection of blood for DNA extraction, was undertaken of all survivors of previous surveys.…”

Assessment of dietary fat intake and innate immune activation as risk factors for impaired lung function

“…Lung function progressively declines with aging (James et al, 2005) and can lead to the development of obstructive lung diseases (OLDs), such as asthma and chronic obstructive pulmonary disease (COPD), which represent a significant and increasing global health problem (Buist et al, 2007). Several studies have also shown that low or declining lung function, measured by forced expiratory volume in one second (FEV 1 ) or forced vital capacity (FVC), is a strong predictor of all-cause (Hole et al, 1996) and cardiovascular mortality (Tockman et al, 1995;Schroeder et al, 2003).…”

“…The factors leading to lung function decline with age are not well understood (James et al, 2005). Both smoking and asthma accelerate lung function decline (James et al, 2005).…”

“…Both smoking and asthma accelerate lung function decline (James et al, 2005). However, lung function also declines in the absence of these exposures, suggesting that other risk factors are important (Buist et al, 2007).…”

A diagnostic approach and natural course of a patient with asthma– COPD overlap syndrome

“…The presented patient did not develop frequent exacerbations, but there was 240 mL reduction in post‐bronchodilator FEV 1 over 4 years (−60 mL/year) after 1.5 year of treatment, suggesting a rapid decline in lung function compared with annual rate of decline in Asian COPD patients. This rapid rate of decline in FEV 1 might be due to the combination of asthma and smoking [6]. Prospective longitudinal studies are necessary to assess the natural course of ACOS with optimal interventions.…”