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Wheeze-free patients at risk based on smoking history, age, chronic bronchitis

Patients with no previous wheeze history appeared at risk for developing wheeze based on factors such as smoking history, age and a history of chronic bronchitis, according to recent research.

“The present prospective study is unique as it presents an incidence rate for new-onset wheeze in a middle-aged, general population previously free of adult wheeze,” Mathias Holm, MD, of the department of occupational and environmental medicine at Sahlgrenska University Hospital in Gothenburg, Sweden, and colleagues wrote. “The results indicate that new-onset wheeze is quite common in middle-aged people. It is thus important for health care staff to be aware of this fact since new-onset wheeze could be the first sign of severe respiratory diseases, like [chronic obstructive pulmonary disease (COPD)], asthma, airway infections, and tumors. Special attention should be paid to patients with a smoking history, chronic bronchitis, rhinitis or obesity.”

Holm and colleagues evaluated results from a respiratory questionnaire sent to 15,813 participants in 2003 from a previous study initiated in 1993; of these participants, 11,463 patients completed the questionnaire, which asked questions about smoking, atopy and respiratory symptoms.

The researchers found 8,885 participants were wheeze-free at baseline and there were 378 new wheeze cases among these patients between 1993 and 2003, with an incident rate of 4.3 per 1,000 person-years, according to the abstract. Factors that increased the adjusted risk at baseline included smoking (HR = 2.1; 95% CI, 1.7-2.7), previous smoking history in non-smokers (HR = 1.4; 95% CI, 1.1-1.9), chronic bronchitis (HR = 2.3; 95% CI, 0.96-5.7), young age (HR = 1.7; 95% CI, 1.3-2.2) and rhinitis (HR = 1.8; 95% CI, 1.4-2.2). Body mass index of 30 or higher increased the adjusted risk at follow-up (HR = 1.9; 95% CI, 1.5-2.6). – by Jeff Craven

Disclosure: The researchers report no relevant financial disclosures.