Prevalence and cause of Dyspnea in a general population: The Tromsø study

Abstract

Background: Dyspnea is a prevalent condition causing reduced quality of life increasingly by age. The main causes are heart failure (HF), chronic obstructive pulmonary disease (COPD) with less common conditions being ischemic dyspnea, heart disease, atrial fibrillation, asthma, and pulmonary fibrosis. The aim of study was to determine causes of dyspnea in a general population through examination with echocardiography and spirometry and determine age and gender specific prevalence of each condition. Methods: This population based cross-sectional study included 11812 (46.9% were men) participants with answered questionnaire data on dyspnea from the sixth survey of Tromsø study. Independent-sample T-test (for continuous variables) and Chi-square test (for categorical variables) were used to explore significant difference in participant´s characteristics between men and women. Differences between groups were compared with ANOVA for continuous variable and logistic regression (univariate / multivariable analysis) was performed with dyspnea along demographic and baseline characteristics, COPD, restrictive disease and spirometry and echocardiography measurement group. Results: Overall 48.6% of the total participants reported dyspnea. Among participants with moderate COPD prevalence of dyspnea was 67.3% for men and 75% for women. The prevalence of enlarged LAD/BSA increased from 15% in subjects without self-reported dyspnea to 30% in moderate dyspnea without further increase with increasing severity. Only 25.2% of the participants reporting dyspnea symptoms had abnormal measurements. Among them only 43.6% of male subjects reporting dyspneic symptoms had abnormal measurements compared to 56.4% of women reporting dyspneic symptoms. Increase in severity of COPD was associated with increased prevalence of dyspnea. Moderate COPD [OR=2.6; 95% CI: 1.5-4.5] and severe COPD [OR=9.4; 95% CI: 2.0-44.7] were significantly associated with increased prevalence of dyspnea. Conclusion: Our study shows a strong association between self-reported dyspnea and diastolic heart failure, restrictive pulmonary disease and increasing levels of COPD.