Underlying conditions contributing to breathlessness in the population

Abstract

Purpose of review Assessment of underlying conditions that contribute to breathlessness is fundamental for symptom management. This review aims to summarize the knowledge from the past two years on the most common underlying conditions among individuals with breathlessness in the general population and to identify research gaps. Recent findings Nine studies from the last two years were included in the review; two studies systematically assessed underlying conditions among breathless individuals in the general population. The modified Medical Research Council (mMRC) scale was used in eight of nine studies. Respiratory diseases were the main underlying condition (40–57%), of which asthma was the most common (approx. 25%), and chronic obstructive pulmonary disease was particularly strongly associated with breathlessness. Other conditions prevalent among breathless individuals included heart diseases, anxiety, depression, and obesity, and several conditions often co-existed. Summary Breathlessness in the general population is common and associated with several underlying conditions. Respiratory disease is the most commonly reported underlying condition. Refined methods such as machine learning could be useful to study the complex interplay between multiple underlying causes of breathlessness and impact on outcomes such as quality of life and survival.

Obesity is a major contributing cause of breathlessness in the population

“…[1][2][3] Among people with breathlessness, obesity is one of the most common underlying conditions, and often coexists with other conditions that potentially contribute to the severity of the symptom. 4,5 Compared with people with normal BMI, breathlessness is more common in people with underweight (BMI <18.5), overweight (BMI 25-30) and especially with obesity (BMI >30)-also after controlling for known confounders such as the presence of other medical conditions. 3,4,6,7 In a recent publication in Respirology, Guo et al 8 take a further step to evaluate the contribution of obesity to breathlessness in the population.…”

“…Both obesity and breathlessness are very common in the population, and are strongly associated with worse health and outcomes 1–3 . Among people with breathlessness, obesity is one of the most common underlying conditions, and often coexists with other conditions that potentially contribute to the severity of the symptom 4,5 . Compared with people with normal BMI, breathlessness is more common in people with underweight (BMI <18.5), overweight (BMI 25–30) and especially with obesity (BMI >30)—also after controlling for known confounders such as the presence of other medical conditions 3,4,6,7 …”

Prevalence, severity and impacts of breathlessness in Indian adults: An exploratory, nationally representative, cross-sectional online survey

“…Living with the symptom of breathlessness, is one of the most debilitating experiences for people with chronic complex or chronic progressive illnesses [ 1 , 2 ]. Breathlessness is associated with poorer quality of life, increased anxiety and depression, worsening function and sexual wellbeing, limited activities of daily living, reduced workforce participation and increased social isolation [ 3 – 9 ].…”

Diagnostic delays for breathlessness in primary care: a qualitative study to investigate current care and inform future pathways

“…9 , 10 Multimorbidity is common in patients with breathlessness, and cross-sectional population studies have shown considerable overlap in the causes of breathlessness. 11 One study showed that 66% of people reporting breathlessness had ≥2 contributing causes to their breathlessness, with respiratory disease and anxiety or depression being the most common combination. 10 The Australian National Breathlessness Survey found that obesity accounted for a quarter of breathlessness symptoms in adults.…”