Bronchial hyperresponsiveness in a population of north Finland with no previous diagnosis of asthma or chronic bronchitis assessed with histamine and methacholine tests

Abstract

Objectives. To assess the prevalence of bronchial hyperresponsiveness (BHR) in a population of north Finland among subjects with no previous diagnosis of asthma or chronic bronchitis by using histamine and methacholine challenges. The agreement between the methods was also evaluated.

Study design. An epidemiological study assessing the prevalence of BHR measured with 2 direct dosimetric challenge methods.

Methods. Seventy-nine randomly selected subjects (21–73 years) were studied; 67% had respiratory or allergic symptoms. The baseline spirometry was normal or showed mild obstruction. Bronchial challenges to methacholine and histamine were performed on each subject in a randomized order. Provocative doses inducing the decrease of FEV1 by 15% and 2 0% (PD15FEV1 and PD20FEV1) and dose response ratios (DDR) were calculated for both tests.

Results. BHR with the methacholine test (PD₂₀FEV₁≤2.6 mg) was found in 20% and with the histamine test (PD₁₅FEV₁≤1.6 mg) in 28% of subjects; the agreement was 80% (kappa 0.45; 95% CI 0.23–0.68). In staging the severity of BHR the methods had a good agreement (weighted kappa 0.64; CI 95% 0.46-0.82). Prevalence of BHR fulfilling the criteria of the both methods was 14%.

Conclusions The findings suggest that the prevalence of BHR in the population of north Finland with no previous diagnosis of asthma or chronic bronchitis is at least 14%, probably around 2 0%, assessed by histamine and methacholine challenge methods. The methods have a good agreement to be used for classifying the severity of BHR.

Keywords:

• bronchial hyperreactivity (BHR)
• histamine
• methacholine
• respiratory symptoms
• nonasthmatics