Bronchodilator response to adrenergic β2β2-agonists: Relationship to symptoms in an adult community

SummaryBackground: Wheeze and chest tightness has traditionally been associated with enhanced bronchial responsiveness. However, no community studies are available on the associations between bronchodilator response and respiratory symptoms among adults.Aim: To examine how respiratory symptoms predict bronchodilator response.Methods  : An age and gender stratified random sample of all adults aged 47–48 and 71–73 years in Bergen, Norway, were invited. The 3506 participants (69%) filled in questionnaires including nine symptoms and performed bronchodilator reversibility tests. Subjects without current anti-asthmatic medication performing acceptable reversibility tests were included in the analyses (n=3088)(n=3088).Results: A reversibility with FEV1 increase ⩾⩾ 12% and ⩾⩾ 200 ml was obtained in 2% of middle-aged and 4% of elderly subjects (p=0.001)(p=0.001). In multiple linear regression analysis bronchodilatation was positively associated with wheezing without cold (FEV1 increase of 1.5%, 95% CI: (0.9, 2.2)% in all participants and 31 ml, 95% CI: (1, 61) ml in men only) and dyspnoea climbing two flights of stairs (0.9%, 95% CI: (0.5,1.4)%(0.5,1.4)% and 12 ml, 95% CI: (1,23)ml). Chronic cough predicted the response negatively (-0.7%(-0.7%, 95% CI: (-1.3,-0.1)%(-1.3,-0.1)% and -17ml, 95% CI: (-32,-2)ml). In multiple logistic regression analysis morning cough predicted an FEV1 increase ⩾⩾ 12% and ⩾⩾ 200 ml (OR: 1.8, 95% CI: (1.1,2.8)(1.1,2.8)).Conclusions: A small fraction of adults in a general population has bronchodilatation after salbutamol inhalation. “Wheezing without cold”, “dyspnoea climbing two flights of stairs”, and “morning cough” predict an increased bronchodilator response among subjects without current anti-asthmatic medications.