Prevalence of airflow limitation in outpatients with cardiovascular diseases in Japan

Onishi, Katsuya; Yoshimoto, Daisuke; Hagan, Gerry; Jones, Paul

doi:10.2147/copd.s59962

Cited by 32 publications

(33 citation statements)

References 27 publications

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“…However, the few studies confirm that reduced pulmonary function is associated with cardiovascular risk factors [1,19]. Multivariate models have also confirmed the independent association of cardiovascular lifestyles, high-risk conditions and lower levels of FEV 1 and FVC.…”

Section: Discussionmentioning

confidence: 91%

Association of Lifestyle and Cardiovascular Risk Factors with Lung Function in a Sample of the Adult Italian Population: A Cross-Sectional Survey

Laurendi

Donfrancesco²,

Palmieri³

et al. 2015

Respiration

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Background: Some epidemiological studies have identified high values of pulmonary functions as an indicator of good health. At present little is known about the distribution of these characteristics in the general adult population. Objective: The aim of this study is to describe pulmonary function in the Italian general population and to evaluate its association with some lifestyle and cardiovascular risk conditions using data of the OEC/HES (Cardiovascular Epidemiology Observatory/Health Examination Survey) Project, a cross-sectional survey based on the examination of random samples of the general population. Methods: A total of 9,108 men and women aged 35-79 years were examined between 2008 and 2012. Pulmonary function [forced expiratory volume in 1 s (FEV₁) and forced vital capacity (FVC)] was measured with a spirometer and anthropometric measurements and blood pressure were also recorded, whereas lifestyle (physical activity, smoking habits), health status and drug treatment were assessed by a questionnaire. FEV₁ and FVC % predicted were also calculated. Univariate analysis and a multiple linear regression were performed in order to assess associations. Results: FVC and FEV₁ percent predicted values were 98.0 (95% CI 97.4-98.6) and 107.3 (95% CI 106.6-107.9) for men and 108.7 (95% CI 107.9-109.4) and 113.3 (95% CI 112.6-114.1) for women. A lower mean FEV₁ and FVC % predicted value was found in smokers, individuals physically inactive during their leisure time, diabetics, obese individuals and hypertensive patients. Multivariate linear regression models confirmed the independent association between risk factors and FEV₁ and FVC levels. Conclusion: Our data confirm the inverse relationship existing between pulmonary function and cardiovascular risk factors, obesity, dyslipidemias and hypertension, all of which are conditions related to chronic diseases. An early public healthcare intervention on lifestyle could be useful to reduce the decline in pulmonary function.

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Section: Discussionmentioning

confidence: 91%

Association of Lifestyle and Cardiovascular Risk Factors with Lung Function in a Sample of the Adult Italian Population: A Cross-Sectional Survey

Laurendi

Donfrancesco²,

Palmieri³

et al. 2015

Respiration

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“…The data from this study regarding the symptoms of patients with undiagnosed airflow limitation have already been published. 8 …”

Section: Methodsmentioning

confidence: 99%

“…The Hi-Checker has been previously demonstrated to be an accurate alternative to the conventional spirometer. 8 FEV 1 and FEV 6 were measured prior to bronchodilator use. Subjects performed forced expiration for 6 seconds until reproducible FEV 6 values were obtained (the difference between the two highest FEV 6 values was not more than 0.10 L).…”

Section: Methodsmentioning

confidence: 99%

“… 4 Previous data have shown that screening spirometry during medical checkups can identify many COPD patients not aware of this disease. 7 The study using a hand-held spirometer showed that underdiagnosis of COPD was particularly a problem in patients with chronic bronchitis and in younger patients, 8 a phenotype that is not usually recognized as COPD in Japan.…”

Section: Introductionmentioning

confidence: 99%

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The relationship between the COPD Assessment Test score and airflow limitation in Japan in patients aged over 40 years with a smoking history

Yoshimoto¹,

Nakano²,

Onishi³

et al. 2014

COPD

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BackgroundA large number of chronic obstructive pulmonary disease (COPD) patients in Japan remain undiagnosed, primarily due to the underuse of spirometry. Two studies were conducted to see whether the COPD Assessment Test (CAT) in primary care has the potential to identify those patients who need spirometry for a diagnosis of COPD and to determine whether patients with cardiovascular disease had airflow limitation, which could be detected by CAT.Materials and methodsTwo multicenter, noninterventional, prospective studies (studies 1 and 2) were conducted across Japan. Patients in both studies were ≥40 years old with a smoking history. Those in study 1 were seen in primary care and had experienced repeated respiratory tract infections, but had no diagnosis of COPD. Patients in study 2 were identified in cardiovascular disease clinics when routinely visiting for their cardiovascular disease. All patients completed the CAT prior to lung-function testing by hand-held spirometry. The presence of airflow limitation was defined as a forced expiratory volume in 1 second (FEV1)/FEV6 ratio <0.73.ResultsA total of 3,062 subjects completed the CAT (2,067 in study 1, 995 in study 2); 88.8% were male, and the mean age (± standard deviation) was 61.5±11.6 years. Airflow limitation was found in 400 (19.4%) patients in study 1, and 269 (27.0%) in study 2. The CAT score in patients with airflow limitation was significantly higher than in patients without airflow limitation in both studies: 8.6 (95% confidence interval [CI] 7.9–9.2) versus 7.4 (95% CI 7.1–7.6) in study 1, and 8.3 (95% CI 7.5–9.2) versus 6.4 (95% CI 6.0–6.8) in study 2 (both P<0.001).ConclusionThese findings suggest that the CAT has the potential to identify patients with cardiovascular disease or a history of frequent chest infections who need spirometry to diagnose COPD.

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“…However, 31.3% did not receive any clinical intervention (smoking cessation advice and/or drug administration). Another study determined the proportion of Japanese patients with smoking histories being treated for cardiovascular disease who had concurrent airflow limitation compatible with COPD 23. The study (N=995) indicated that a quarter of outpatients with cardiovascular disease had COPD, but in almost all of them, the condition was undiagnosed.…”

Section: Epidemiology and Treatment Of Copd In Japanmentioning

confidence: 99%

LAMA/LABA vs ICS/LABA in the treatment of COPD in Japan based on the disease phenotypes

Hizawa¹

2015

COPD

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In the combined use of bronchodilators of different classes, ie, long-acting β2-agonists (LABAs) and long-acting muscarinic antagonists (LAMAs), bronchodilation is obtained both directly, through LABA-mediated stimulation of β2-adrenergic receptors, and indirectly, through LAMA-mediated inhibition of acetylcholine action at muscarinic receptors. The clinical trial data for LABAs/LAMAs in the treatment of chronic obstructive pulmonary disease (COPD) continue to be promising, and these combinations will provide the convenience of delivering the two major bronchodilator classes, recommended as first-line maintenance options in COPD treatment guidelines. COPD is a complex condition that has pulmonary and extrapulmonary manifestations. These clinical manifestations are highly variable, and several are associated with different responses to currently available therapies. The concept of a COPD phenotype is rapidly evolving from one focusing on the clinical characteristics to one linking the underlying biology to the phenotype of the disease. Identification of the peculiarities of the different COPD phenotypes will permit us to implement a more personalized treatment in which the patient’s characteristics, together with his or her genotype, will be key to choosing the best treatment option. At present in Japan, fixed combinations of inhaled corticosteroids (ICSs) and LABAs are frequently prescribed in the earlier stages of COPD. However, ICSs increase the risk of pneumonia. Notably, 10%–30% of patients with COPD with or without a history of asthma have persistent circulating and airway eosinophilia associated with an increased risk of exacerbations and sensitivity to steroids. Thus, sputum or blood eosinophil counts might identify a subpopulation in which ICSs could have potentially deleterious effects as well as a subpopulation that benefits from ICSs. In this review, I propose one plausible approach to position ICSs and LABAs/LAMAs in clinical practice, based on both the extent of airflow obstruction and the presence of an asthma component or airway eosinophilic inflammation. This approach is a tentative move toward personalized treatment for COPD patients, and with progress in knowledge and developments in physiology, lung imaging, medical biology, and genetics, identification of COPD phenotypes that provide prognostic and therapeutic information that can affect clinically meaningful outcomes is an urgent medical need.

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Prevalence of airflow limitation in outpatients with cardiovascular diseases in Japan

Cited by 32 publications

References 27 publications

Association of Lifestyle and Cardiovascular Risk Factors with Lung Function in a Sample of the Adult Italian Population: A Cross-Sectional Survey

Association of Lifestyle and Cardiovascular Risk Factors with Lung Function in a Sample of the Adult Italian Population: A Cross-Sectional Survey

The relationship between the COPD Assessment Test score and airflow limitation in Japan in patients aged over 40 years with a smoking history

LAMA/LABA vs ICS/LABA in the treatment of COPD in Japan based on the disease phenotypes

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