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Relationship between FEV₁ reduction and respiratory symptoms in the general population

¹ Division of Respiratory Medicine, University of Nottingham, Nottingham, UK. ² Channing Laboratory, Harvard, Cambridge, MA, USA

CORRESPONDENCE: J. Britton, Division of Respiratory Medicine, City Hospital, Nottingham NG5 1PB, UK. Fax: 44 1158404771. E-mail: j.britton@virgin.net

Keywords: lung function, respiratory symptoms

Received: August 2, 2002
Accepted October 28, 2002

This study was funded by the National Asthma Campaign and the British Lung Foundation.

Obstructive airways diseases typically present with dyspnoea, cough and wheeze, and are defined by a reduced forced expiratory volume in one second (FEV₁)/forced vital capacity (FVC) ratio. Traditionally, however, the severity of chronic obstructive pulmonary disease is graded by the FEV₁ % predicted rather than the FEV₁/FVC ratio, whilst other potentially valid measures of FEV₁ impairment, such as the absolute difference of FEV₁ from predicted or the absolute level of FEV₁, tend not to be used. The authors have therefore explored the relationship between these different measures of FEV₁ impairment and chronic respiratory symptoms in a general population sample.

FEV₁ and FVC were measured and questionnaire data were obtained on cough, wheeze, shortness of breath and general self-reported breathing trouble in a cross-sectional survey of 2,633 adults aged 18–70 yrs from a district of Nottingham, UK. Odds ratios for each symptom were calculated for declining levels of absolute FEV₁, FEV₁ % pred, absolute difference of FEV₁ from predicted, and FEV₁/FVC ratio. They were plotted to display the shape and strength of these relationships before and after adjustment for each other measure.

The odds of symptoms increased with declining levels of all FEV₁ measures, particularly for wheeze and general breathing trouble. Although this study was not sufficiently powerful to detect significant differences between measures, these relationships were consistently strongest, before and after adjustment, for FEV₁ % pred, particularly below a threshold of 75%.

The authors conclude that forced expiratory volume in one second % predicted appears to be the measure of airflow impairment most closely associated with chronic respiratory symptoms in the general population.

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