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Longitudinal Analysis of PRISm Conducted in Large Adult Population

Preserved ratio impaired spirometry associated with increased risks for breathlessness and cardiovascular disease

WEDNESDAY, Nov. 10, 2021 (HealthDay News) — Preserved ratio impaired spirometry (PRISm), which is defined as a forced expiratory volume in one second (FEV1) of less than 80 percent predicted and an FEV1/forced vital capacity ratio of 0.70 or higher, has a prevalence of 11 percent in a large, adult general population and is associated with obesity, current smoking, and asthma, according to a study published online Nov. 2 in The Lancet Respiratory Medicine.

Daniel H. Higbee, M.B.B.S., from the University of Bristol in the United Kingdom, and colleagues examined PRISm prevalence, risk factors and associated symptoms, and associated comorbidities among 351,874 U.K. Biobank participants, with a median follow-up of 9.0 years.

The researchers found that 11 percent of participants had PRISm at baseline. There were strong associations observed for PRISm with obesity, current smoking, and patient-reported doctor-diagnosed asthma after adjustment (odds ratios, 2.40, 1.48, and 1.76, respectively). Female sex, being overweight, trunk fat mass, and trunk fat percentage were also risk factors. There was a strong association seen for PRISm-associated symptoms and comorbidity, including an increased risk for breathlessness and cardiovascular disease (adjusted odds ratios, 2.0 for breathlessness and 1.71 for myocardial infarction). In a longitudinal analysis, 12.3 percent of the participants with PRISm at baseline had transitioned to airflow obstruction consistent with chronic obstructive pulmonary disease. Compared with controls, individuals with PRISm had increased all-cause mortality (adjusted hazard ratio, 1.61).

“Although for many patients PRISm is transient, it is important to understand which individuals are at risk of progressive lung function abnormalities,” a coauthor said in a statement.

One author disclosed financial ties to the pharmaceutical industry

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