Respiratory Research (Mar 2024)

Exertional breathlessness related to medical conditions in middle-aged people: the population-based SCAPIS study of more than 25,000 men and women

  • Magnus Ekström,
  • Josefin Sundh,
  • Anders Andersson,
  • Oskar Angerås,
  • Anders Blomberg,
  • Mats Börjesson,
  • Kenneth Caidahl,
  • Össur Ingi Emilsson,
  • Jan Engvall,
  • Erik Frykholm,
  • Ludger Grote,
  • Kristofer Hedman,
  • Tomas Jernberg,
  • Eva Lindberg,
  • Andrei Malinovschi,
  • André Nyberg,
  • Eric Rullman,
  • Jacob Sandberg,
  • Magnus Sköld,
  • Nikolai Stenfors,
  • Johan Sundström,
  • Hanan Tanash,
  • Suneela Zaigham,
  • Carl-Johan Carlhäll

DOI
https://doi.org/10.1186/s12931-024-02766-6
Journal volume & issue
Vol. 25, no. 1
pp. 1 – 12

Abstract

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Abstract Background Breathlessness is common in the population and can be related to a range of medical conditions. We aimed to evaluate the burden of breathlessness related to different medical conditions in a middle-aged population. Methods Cross-sectional analysis of the population-based Swedish CArdioPulmonary bioImage Study of adults aged 50–64 years. Breathlessness (modified Medical Research Council [mMRC] ≥ 2) was evaluated in relation to self-reported symptoms, stress, depression; physician-diagnosed conditions; measured body mass index (BMI), spirometry, venous haemoglobin concentration, coronary artery calcification and stenosis [computer tomography (CT) angiography], and pulmonary emphysema (high-resolution CT). For each condition, the prevalence and breathlessness population attributable fraction (PAF) were calculated, overall and by sex, smoking history, and presence/absence of self-reported cardiorespiratory disease. Results We included 25,948 people aged 57.5 ± [SD] 4.4; 51% women; 37% former and 12% current smokers; 43% overweight (BMI 25.0–29.9), 21% obese (BMI ≥ 30); 25% with respiratory disease, 14% depression, 9% cardiac disease, and 3% anemia. Breathlessness was present in 3.7%. Medical conditions most strongly related to the breathlessness prevalence were (PAF 95%CI): overweight and obesity (59.6–66.0%), stress (31.6–76.8%), respiratory disease (20.1–37.1%), depression (17.1–26.6%), cardiac disease (6.3–12.7%), anemia (0.8–3.3%), and peripheral arterial disease (0.3–0.8%). Stress was the main factor in women and current smokers. Conclusion Breathlessness mainly relates to overweight/obesity and stress and to a lesser extent to comorbidities like respiratory, depressive, and cardiac disorders among middle-aged people in a high-income setting—supporting the importance of lifestyle interventions to reduce the burden of breathlessness in the population.

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