Full Length Research Paper
Abstract
Asthma is the most common chronic lung disease. The fate of patients with long standing (LS) asthma is of interest. The large number of LS asthmatics at two inner-city hospitals was an impetus to this study, LS asthma: > 30 years. All patients were non-smokers or minimal smokers and had no other lung disease. Data obtained: gender, race, age, body mass index (BMI), forced expiratory volume in 1 second (FEV1), FEV1% predicted, forced vital capacity (FVC), FVC% predicted, FEV1/FVC, diffusion capacity for carbon monoxide percent (DLCO%) predicted, functional residual capacity (FRC), inhaled bronchodilator (BD) usage and response, and inhaled corticosteroid (ICS) usage. For the 65 patients, 37 (57%) were black, 48 (74%) were females, mean age was 53.0 ± 14.7, and 58 (89%) were overweight/obese. FEV1 and FVC% predicted were slightly/moderately reduced in 26 and 24 patients; severely reduced in 27 and 17%, respectively. FEV1/FVC was slightly reduced in 17%, moderately/severely reduced in 11% and was normal in 37%. DLCO% predicted was normal in 28%, slightly/moderately reduced in 31% and was severely reduced in 6%. FRC was increased in only 37%. A typical LS asthmatic is an overweight/obese woman who has a decreased DLCO, FEV1 and FVC, a normal or slightly decreased FEV1/FVC and FRC, and regularly uses BD/ICS without an acute BD response. Using FEV1/FVC ratio to diagnose or follow patients with asthma can be misleading.
Key words: Long standing asthma, obesity, bronchodilator response, restrictive impairment, diffusing capacity, pulmonary vasculopathy
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