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Percorrer por autor "Devereux, Graham"

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  • Bronchodilator responsiveness and future chronic airflow obstruction: a multinational longitudinal study
    Publication . Knox-Brown, Ben; Algharbi, Fahad; Mulhern, Octavia; Potts, James; Harrabi, Imed; Janson, Christer; Nielsen, Rune; Agarwal, Dhiraj; Malinovschi, Andrei; Juvekar, Sanjay; Denguezli, Miriam; Gíslason, Thorarinn; Ahmed, Rana; Nafees, Asaad; Koul, Parvaiz A.; Obaseki, Daniel; Anand, Mahesh Padukudru; Loh, Li Cher; Hermínia Brites Dias; Rodrigues, Fátima; Mannino, David; Elbiaze, Mohammed; El Rhazi, Karima; Mejza, Filip; Devereux, Graham; Franssen, Frits; El Sony, Asma; Wouters, Emiel; Al Ghobain, Mohammed; Mortimer, Kevin; Rashid, Abdul; Osman, Rashid; Studnicka, Michael; Cardoso, João; Burney, Peter; Amaral, André; BOLD Collaborative Research Group
    Background: Bronchodilator responsiveness testing is mainly used for diagnosing asthma. We aimed to investigate whether it is associated with progression to chronic airflow obstruction over time. Methods: The multinational Burden of Obstructive Lung Disease cohort study surveyed adults, aged 40 years and above, at baseline and followed them up after a mean of 9.1 years. Recruitment took place between January 2, 2003, and December 26, 2016. Follow-up measurements were collected between January 29, 2019, and October 24, 2021. On both occasions, study participants provided information on respiratory symptoms, health status, and several environmental and lifestyle exposures. They also underwent pre- and post-bronchodilator spirometry. We defined bronchodilator responsiveness at baseline using the American Thoracic Society and European Respiratory Society (ATS/ERS) 2022 definition, and the presence of chronic airflow obstruction at follow-up as a post-bronchodilator forced expiratory volume in 1 s to forced vital capacity ratio (FEV1/FVC) less than the lower limit of normal. We used multi-level regression models to estimate the association between baseline bronchodilator responsiveness and incident chronic airflow obstruction. We stratified analyses by gender and performed a sensitivity analysis in never smokers. Findings: We analysed data from 3701 adults with 56% being women. Compared to those without bronchodilator responsiveness at baseline, those with bronchodilator responsiveness had a 36% increased risk of developing chronic airflow obstruction (RR: 1.36, 95%CI 1.04, 1.80). This effect was stronger in women (RR: 1.45, 95%CI 1.09, 1.91) than in men (RR: 1.07, 95%CI 0.51, 2.24). Never smokers with bronchodilator responsiveness also were at greater risk of incident chronic airflow obstruction (RR: 1.48, 95%CI 1.01, 2.20). Interpretation: Bronchodilator responsiveness appears to be a risk factor for incident chronic airflow obstruction. It is important that future studies in other large population-based cohorts replicate these findings.
    2025-03Artigo científico Acesso aberto Ver mais
  • A cohort study of forced vital capacity, airway obstruction, and survival in the multinational Burden of Obstructive Lung Disease study
    Publication . Burney, Peter G. J.; Bagkeris, Emmanouil; Potts, James; Nielsen, Rune; Devereux, Graham; El Rhazi, Karima; Aquart-Stewart, Althea; Nafees, Asaad A.; Koul, Parvaiz; Mahesh, Padukudru Anand; Agarwal, Dhiraj; Juvekar, Sanjay; Gislason, Thorarinn; Dias, Maria Hermínia Monteiro Brites
    Background: In the USA, higher forced vital capacity (FVC) is linked with longer survival, and FVC is associated with survival independently of ethnicity. The implications for the low FVC values in parts of Asia and Africa are unknown. Methods: We used data from 16 sites of the multinational Burden of Obstructive Lung Disease (BOLD) study that completed follow-up of participants between 2019 and 2021 and reported at least five deaths between baseline and follow-up. We assessed the association of mortality with FVC and Forced Expiratory Volume in 1 second (FEV1)/FVC ratio within each site using Cox proportional hazards models. These models were adjusted for age, smoking, height, and weight. Effect estimates from all sites were combined using meta-analysis. Systematic regional differences were investigated. Results: Of 9927 study participants with follow-up data, 1120 (11.3%) had died [mean follow-up = 8.7 years, standard deviation (SD) = 3.3 years]. Baseline post-bronchodilator FVC and FEV1/FVC were inversely associated with mortality. When both FVC and FEV1/FVC were mutually adjusted for each other, the decreased mortality rates were more pronounced for each SD higher FVC at baseline [44% (95% confidence interval (CI): 25%, 58%) for men and 28% (95% CI: 11%, 41%) for women] than for FEV1/FVC at baseline [14% (95% CI: 8%, 20%) for men and 7% (95% CI: -10%, 21%) for women]. The probability of true regional differences was low. Conclusions: People with a higher FVC adjusted for age, sex, and height have a longer survival. Regional adjustments to lung function standards are inappropriate when assessing prognosis.
    2026-04Artigo científico Acesso aberto Ver mais