Correlates of peak expiratory flow lability in elderly persons

Paul L. Enright; Robyn L. McClelland; A. Sonia Buist; Michael D. Lebowitz; Sharon Jackson; Alan Elster; Curt D. Furberg; Gerardo Heiss; Dalane Kitzman; Margie Lamb; David S. Lefkowitz; Mary F. Lyles; Cathy Nunn; Ward Riley; John Chen; Beverly Tucker; Farida Rautaharju; Pentti Rautaharju; William Bonekat; Charles Bernick; Michael Buonocore; Mary Haan; Calvin Hirsch; Lawrence Laslett; Marshall Lee; John Robbins; William Seavey; Richard White; M. Jan Busby-Whitehead; Joyce Chabot; George W. Comstock; Adrian Dobs; Linda P. Fried; Joel G. Hill; Steven J. Kittner; Shiriki Kumanyika; David Levine; Joao A. Lima; Neil R. Powe; Thomas R. Price; Jeff Williamson; Moyses Szklo; Melvyn Tockman; Norman Beauchamp; R. Nick Bryan; Douglas Fellows; Melanie Hawkins; Patrice Holtz; Naiyer Iman; Michael Kraut; Cynthia Quinn; Grace Lee; Carolyn C. Meltzer; Larry Schertz; Earl P. Steinberg; Scott Wells; Linda Wilkins; Nancy C. Yue; Diane G. Ives; Charles A. Jungreis; Laurie Knepper; Lewis H. Kuller; Elaine Meilahn; Peg Meyer; Roberta Moyer; Anne Newman; Richard Schulz; Vivienne E. Smith; Sidney K. Wolfson; Hoda Anton-Culver; Julius M. Gardin; Margaret Knoll; Tom Kurosaki; Nathan Wong; John Gottdiener; Eva Hausner; Stephen Kraus; Judy Gay; Sue Livengood; Mary Ann Yohe; Retha Webb; Daniel H. O’leary; Joseph F. Polak; Laurie Funk; Elaine Cornell; Mary Cushman; Russell P. Tracy; Paul Enright; Alice Arnold; Annette L. Fitzpatrick; Richard A. Kronmal; Bruce M. Psaty; David S. Siscovick; Will Longstreth; Patricia W. Wahl; Norbert Yanez; Paula Diehr; Corrine Dulberg; Bonnie Lind; Thomas Lumley; Ellen O’meara; Jennifer Nelson; Charles Spiekerman; Robin Boineau; Teri A. Manolio; Peter J. Savage; Patricia Smith

doi:10.1378/chest.120.6.1861

Correlates of peak expiratory flow lability in elderly persons

Paul L. Enright, Robyn L. McClelland, A. Sonia Buist, Michael D. Lebowitz, Sharon Jackson, Alan Elster, Curt D. Furberg, Gerardo Heiss, Dalane Kitzman, Margie Lamb, David S. Lefkowitz, Mary F. Lyles, Cathy Nunn, Ward Riley, John Chen, Beverly Tucker, Farida Rautaharju, Pentti Rautaharju, William Bonekat, Charles BernickMichael Buonocore, Mary Haan, Calvin Hirsch, Lawrence Laslett, Marshall Lee, John Robbins, William Seavey, Richard White, M. Jan Busby-Whitehead, Joyce Chabot, George W. Comstock, Adrian Dobs, Linda P. Fried, Joel G. Hill, Steven J. Kittner, Shiriki Kumanyika, David Levine, Joao A. Lima, Neil R. Powe, Thomas R. Price, Jeff Williamson, Moyses Szklo, Melvyn Tockman, Norman Beauchamp, R. Nick Bryan, Douglas Fellows, Melanie Hawkins, Patrice Holtz, Naiyer Iman, Michael Kraut, Cynthia Quinn, Grace Lee, Carolyn C. Meltzer, Larry Schertz, Earl P. Steinberg, Scott Wells, Linda Wilkins, Nancy C. Yue, Diane G. Ives, Charles A. Jungreis, Laurie Knepper, Lewis H. Kuller, Elaine Meilahn, Peg Meyer, Roberta Moyer, Anne Newman, Richard Schulz, Vivienne E. Smith, Sidney K. Wolfson, Hoda Anton-Culver, Julius M. Gardin, Margaret Knoll, Tom Kurosaki, Nathan Wong, John Gottdiener, Eva Hausner, Stephen Kraus, Judy Gay, Sue Livengood, Mary Ann Yohe, Retha Webb, Daniel H. O’leary, Joseph F. Polak, Laurie Funk, Elaine Cornell, Mary Cushman, Russell P. Tracy, Paul Enright, Alice Arnold, Annette L. Fitzpatrick, Richard A. Kronmal, Bruce M. Psaty, David S. Siscovick, Will Longstreth, Patricia W. Wahl, Norbert Yanez, Paula Diehr, Corrine Dulberg, Bonnie Lind, Thomas Lumley, Ellen O’meara, Jennifer Nelson, Charles Spiekerman, Robin Boineau, Teri A. Manolio, Peter J. Savage, Patricia Smith

Pulmonary and Critical Care Medicine

Research output: Contribution to journal › Article › peer-review

17 Scopus citations

Abstract

Objective: To determine the correlates of the lability of peak expiratory flow (PEF) in the elderly. Methods: A community sample of 4,581 persons ≥ 65 years old from the Cardiovascular Health Study completed an asthma questionnaire and underwent spirometry. During a follow-up examination of the cohort, 1,836 persons agreed to measure PEF at home twice daily for 2 weeks, and 90% successfully obtained at least 4 days of valid measurements. PEF lability was calculated as the highest daily (PEF maximum - PEF minimum)/mean PEF. Results: Mean PEF measured at home was accurate when compared to PEF determined by spirometry in the clinic. Mean PEF lability was 18% in those with current asthma (n = 165) vs 12% in healthy nonsmokers (upper limit of normal, 29%). Approximately 26% of those with asthma and 14% of the other participants had abnormally high PEF lability (> 29%). After excluding participants with asthma, other independent predictors of high PEF lability included black race, current and former smoking, airway obstruction on spirometry, daytime sleepiness, recent wheezing, chronic cough, emphysema, and wheezing from lying in a supine position. Despite having a lower mean PEF, those reporting congestive heart failure (n = 82) did not have significantly higher PEF lability. Conclusions: Measurement of PEF lability at home is highly successful in elderly persons. PEF lability ≥ 30% is abnormal in the elderly and is associated with asthma.

Original language	English (US)
Pages (from-to)	1861-1868
Number of pages	8
Journal	CHEST
Volume	120
Issue number	6
DOIs	https://doi.org/10.1378/chest.120.6.1861
State	Published - Dec 2001

Keywords

Airway lability
Asthma
Elderly
Peak expiratory flow

ASJC Scopus subject areas

Pulmonary and Respiratory Medicine
Critical Care and Intensive Care Medicine
Cardiology and Cardiovascular Medicine

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10.1378/chest.120.6.1861

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Enright, P. L., McClelland, R. L., Buist, A. S., Lebowitz, M. D., Jackson, S., Elster, A., Furberg, C. D., Heiss, G., Kitzman, D., Lamb, M., Lefkowitz, D. S., Lyles, M. F., Nunn, C., Riley, W., Chen, J., Tucker, B., Rautaharju, F., Rautaharju, P., Bonekat, W., ... Smith, P. (2001). Correlates of peak expiratory flow lability in elderly persons. CHEST, 120(6), 1861-1868. https://doi.org/10.1378/chest.120.6.1861

Enright, PL, McClelland, RL, Buist, AS, Lebowitz, MD, Jackson, S, Elster, A, Furberg, CD, Heiss, G, Kitzman, D, Lamb, M, Lefkowitz, DS, Lyles, MF, Nunn, C, Riley, W, Chen, J, Tucker, B, Rautaharju, F, Rautaharju, P, Bonekat, W, Bernick, C, Buonocore, M, Haan, M, Hirsch, C, Laslett, L, Lee, M, Robbins, J, Seavey, W, White, R, Busby-Whitehead, MJ, Chabot, J, Comstock, GW, Dobs, A, Fried, LP, Hill, JG, Kittner, SJ, Kumanyika, S, Levine, D, Lima, JA, Powe, NR, Price, TR, Williamson, J, Szklo, M, Tockman, M, Beauchamp, N, Bryan, RN, Fellows, D, Hawkins, M, Holtz, P, Iman, N, Kraut, M, Quinn, C, Lee, G, Meltzer, CC, Schertz, L, Steinberg, EP, Wells, S, Wilkins, L, Yue, NC, Ives, DG, Jungreis, CA, Knepper, L, Kuller, LH, Meilahn, E, Meyer, P, Moyer, R, Newman, A, Schulz, R, Smith, VE, Wolfson, SK, Anton-Culver, H, Gardin, JM, Knoll, M, Kurosaki, T, Wong, N, Gottdiener, J, Hausner, E, Kraus, S, Gay, J, Livengood, S, Yohe, MA, Webb, R, O’leary, DH, Polak, JF, Funk, L, Cornell, E, Cushman, M, Tracy, RP, Enright, P, Arnold, A, Fitzpatrick, AL, Kronmal, RA, Psaty, BM, Siscovick, DS, Longstreth, W, Wahl, PW, Yanez, N, Diehr, P, Dulberg, C, Lind, B, Lumley, T, O’meara, E, Nelson, J, Spiekerman, C, Boineau, R, Manolio, TA, Savage, PJ & Smith, P 2001, 'Correlates of peak expiratory flow lability in elderly persons', CHEST, vol. 120, no. 6, pp. 1861-1868. https://doi.org/10.1378/chest.120.6.1861

@article{7d8c78894a16452dba947ea34e119709,

title = "Correlates of peak expiratory flow lability in elderly persons",

abstract = "Objective: To determine the correlates of the lability of peak expiratory flow (PEF) in the elderly. Methods: A community sample of 4,581 persons ≥ 65 years old from the Cardiovascular Health Study completed an asthma questionnaire and underwent spirometry. During a follow-up examination of the cohort, 1,836 persons agreed to measure PEF at home twice daily for 2 weeks, and 90% successfully obtained at least 4 days of valid measurements. PEF lability was calculated as the highest daily (PEF maximum - PEF minimum)/mean PEF. Results: Mean PEF measured at home was accurate when compared to PEF determined by spirometry in the clinic. Mean PEF lability was 18% in those with current asthma (n = 165) vs 12% in healthy nonsmokers (upper limit of normal, 29%). Approximately 26% of those with asthma and 14% of the other participants had abnormally high PEF lability (> 29%). After excluding participants with asthma, other independent predictors of high PEF lability included black race, current and former smoking, airway obstruction on spirometry, daytime sleepiness, recent wheezing, chronic cough, emphysema, and wheezing from lying in a supine position. Despite having a lower mean PEF, those reporting congestive heart failure (n = 82) did not have significantly higher PEF lability. Conclusions: Measurement of PEF lability at home is highly successful in elderly persons. PEF lability ≥ 30% is abnormal in the elderly and is associated with asthma.",

keywords = "Airway lability, Asthma, Elderly, Peak expiratory flow",

author = "Enright, {Paul L.} and McClelland, {Robyn L.} and Buist, {A. Sonia} and Lebowitz, {Michael D.} and Sharon Jackson and Alan Elster and Furberg, {Curt D.} and Gerardo Heiss and Dalane Kitzman and Margie Lamb and Lefkowitz, {David S.} and Lyles, {Mary F.} and Cathy Nunn and Ward Riley and John Chen and Beverly Tucker and Farida Rautaharju and Pentti Rautaharju and William Bonekat and Charles Bernick and Michael Buonocore and Mary Haan and Calvin Hirsch and Lawrence Laslett and Marshall Lee and John Robbins and William Seavey and Richard White and Busby-Whitehead, {M. Jan} and Joyce Chabot and Comstock, {George W.} and Adrian Dobs and Fried, {Linda P.} and Hill, {Joel G.} and Kittner, {Steven J.} and Shiriki Kumanyika and David Levine and Lima, {Joao A.} and Powe, {Neil R.} and Price, {Thomas R.} and Jeff Williamson and Moyses Szklo and Melvyn Tockman and Norman Beauchamp and Bryan, {R. Nick} and Douglas Fellows and Melanie Hawkins and Patrice Holtz and Naiyer Iman and Michael Kraut and Cynthia Quinn and Grace Lee and Meltzer, {Carolyn C.} and Larry Schertz and Steinberg, {Earl P.} and Scott Wells and Linda Wilkins and Yue, {Nancy C.} and Ives, {Diane G.} and Jungreis, {Charles A.} and Laurie Knepper and Kuller, {Lewis H.} and Elaine Meilahn and Peg Meyer and Roberta Moyer and Anne Newman and Richard Schulz and Smith, {Vivienne E.} and Wolfson, {Sidney K.} and Hoda Anton-Culver and Gardin, {Julius M.} and Margaret Knoll and Tom Kurosaki and Nathan Wong and John Gottdiener and Eva Hausner and Stephen Kraus and Judy Gay and Sue Livengood and Yohe, {Mary Ann} and Retha Webb and O{\textquoteright}leary, {Daniel H.} and Polak, {Joseph F.} and Laurie Funk and Elaine Cornell and Mary Cushman and Tracy, {Russell P.} and Paul Enright and Alice Arnold and Fitzpatrick, {Annette L.} and Kronmal, {Richard A.} and Psaty, {Bruce M.} and Siscovick, {David S.} and Will Longstreth and Wahl, {Patricia W.} and Norbert Yanez and Paula Diehr and Corrine Dulberg and Bonnie Lind and Thomas Lumley and Ellen O{\textquoteright}meara and Jennifer Nelson and Charles Spiekerman and Robin Boineau and Manolio, {Teri A.} and Savage, {Peter J.} and Patricia Smith",

note = "Funding Information: The research reported in this article was supported by contracts N01-HC-85079 and N01-HC-85086 from the National Heart, Lung, and Blood Institute, and Georgetown Echo RC-HL 35129, and JHU MRI RC-HL 15103. ",

year = "2001",

month = dec,

doi = "10.1378/chest.120.6.1861",

language = "English (US)",

volume = "120",

pages = "1861--1868",

journal = "CHEST",

issn = "0012-3692",

publisher = "American College of Chest Physicians",

number = "6",

}

TY - JOUR

T1 - Correlates of peak expiratory flow lability in elderly persons

AU - Enright, Paul L.

AU - McClelland, Robyn L.

AU - Buist, A. Sonia

AU - Lebowitz, Michael D.

AU - Jackson, Sharon

AU - Elster, Alan

AU - Furberg, Curt D.

AU - Heiss, Gerardo

AU - Kitzman, Dalane

AU - Lamb, Margie

AU - Lefkowitz, David S.

AU - Lyles, Mary F.

AU - Nunn, Cathy

AU - Riley, Ward

AU - Chen, John

AU - Tucker, Beverly

AU - Rautaharju, Farida

AU - Rautaharju, Pentti

AU - Bonekat, William

AU - Bernick, Charles

AU - Buonocore, Michael

AU - Haan, Mary

AU - Hirsch, Calvin

AU - Laslett, Lawrence

AU - Lee, Marshall

AU - Robbins, John

AU - Seavey, William

AU - White, Richard

AU - Busby-Whitehead, M. Jan

AU - Chabot, Joyce

AU - Comstock, George W.

AU - Dobs, Adrian

AU - Fried, Linda P.

AU - Hill, Joel G.

AU - Kittner, Steven J.

AU - Kumanyika, Shiriki

AU - Levine, David

AU - Lima, Joao A.

AU - Powe, Neil R.

AU - Price, Thomas R.

AU - Williamson, Jeff

AU - Szklo, Moyses

AU - Tockman, Melvyn

AU - Beauchamp, Norman

AU - Bryan, R. Nick

AU - Fellows, Douglas

AU - Hawkins, Melanie

AU - Holtz, Patrice

AU - Iman, Naiyer

AU - Kraut, Michael

AU - Quinn, Cynthia

AU - Lee, Grace

AU - Meltzer, Carolyn C.

AU - Schertz, Larry

AU - Steinberg, Earl P.

AU - Wells, Scott

AU - Wilkins, Linda

AU - Yue, Nancy C.

AU - Ives, Diane G.

AU - Jungreis, Charles A.

AU - Knepper, Laurie

AU - Kuller, Lewis H.

AU - Meilahn, Elaine

AU - Meyer, Peg

AU - Moyer, Roberta

AU - Newman, Anne

AU - Schulz, Richard

AU - Smith, Vivienne E.

AU - Wolfson, Sidney K.

AU - Anton-Culver, Hoda

AU - Gardin, Julius M.

AU - Knoll, Margaret

AU - Kurosaki, Tom

AU - Wong, Nathan

AU - Gottdiener, John

AU - Hausner, Eva

AU - Kraus, Stephen

AU - Gay, Judy

AU - Livengood, Sue

AU - Yohe, Mary Ann

AU - Webb, Retha

AU - O’leary, Daniel H.

AU - Polak, Joseph F.

AU - Funk, Laurie

AU - Cornell, Elaine

AU - Cushman, Mary

AU - Tracy, Russell P.

AU - Enright, Paul

AU - Arnold, Alice

AU - Fitzpatrick, Annette L.

AU - Kronmal, Richard A.

AU - Psaty, Bruce M.

AU - Siscovick, David S.

AU - Longstreth, Will

AU - Wahl, Patricia W.

AU - Yanez, Norbert

AU - Diehr, Paula

AU - Dulberg, Corrine

AU - Lind, Bonnie

AU - Lumley, Thomas

AU - O’meara, Ellen

AU - Nelson, Jennifer

AU - Spiekerman, Charles

AU - Boineau, Robin

AU - Manolio, Teri A.

AU - Savage, Peter J.

AU - Smith, Patricia

N1 - Funding Information: The research reported in this article was supported by contracts N01-HC-85079 and N01-HC-85086 from the National Heart, Lung, and Blood Institute, and Georgetown Echo RC-HL 35129, and JHU MRI RC-HL 15103.

PY - 2001/12

Y1 - 2001/12

N2 - Objective: To determine the correlates of the lability of peak expiratory flow (PEF) in the elderly. Methods: A community sample of 4,581 persons ≥ 65 years old from the Cardiovascular Health Study completed an asthma questionnaire and underwent spirometry. During a follow-up examination of the cohort, 1,836 persons agreed to measure PEF at home twice daily for 2 weeks, and 90% successfully obtained at least 4 days of valid measurements. PEF lability was calculated as the highest daily (PEF maximum - PEF minimum)/mean PEF. Results: Mean PEF measured at home was accurate when compared to PEF determined by spirometry in the clinic. Mean PEF lability was 18% in those with current asthma (n = 165) vs 12% in healthy nonsmokers (upper limit of normal, 29%). Approximately 26% of those with asthma and 14% of the other participants had abnormally high PEF lability (> 29%). After excluding participants with asthma, other independent predictors of high PEF lability included black race, current and former smoking, airway obstruction on spirometry, daytime sleepiness, recent wheezing, chronic cough, emphysema, and wheezing from lying in a supine position. Despite having a lower mean PEF, those reporting congestive heart failure (n = 82) did not have significantly higher PEF lability. Conclusions: Measurement of PEF lability at home is highly successful in elderly persons. PEF lability ≥ 30% is abnormal in the elderly and is associated with asthma.

AB - Objective: To determine the correlates of the lability of peak expiratory flow (PEF) in the elderly. Methods: A community sample of 4,581 persons ≥ 65 years old from the Cardiovascular Health Study completed an asthma questionnaire and underwent spirometry. During a follow-up examination of the cohort, 1,836 persons agreed to measure PEF at home twice daily for 2 weeks, and 90% successfully obtained at least 4 days of valid measurements. PEF lability was calculated as the highest daily (PEF maximum - PEF minimum)/mean PEF. Results: Mean PEF measured at home was accurate when compared to PEF determined by spirometry in the clinic. Mean PEF lability was 18% in those with current asthma (n = 165) vs 12% in healthy nonsmokers (upper limit of normal, 29%). Approximately 26% of those with asthma and 14% of the other participants had abnormally high PEF lability (> 29%). After excluding participants with asthma, other independent predictors of high PEF lability included black race, current and former smoking, airway obstruction on spirometry, daytime sleepiness, recent wheezing, chronic cough, emphysema, and wheezing from lying in a supine position. Despite having a lower mean PEF, those reporting congestive heart failure (n = 82) did not have significantly higher PEF lability. Conclusions: Measurement of PEF lability at home is highly successful in elderly persons. PEF lability ≥ 30% is abnormal in the elderly and is associated with asthma.

KW - Airway lability

KW - Asthma

KW - Elderly

KW - Peak expiratory flow

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U2 - 10.1378/chest.120.6.1861

DO - 10.1378/chest.120.6.1861

M3 - Article

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AN - SCOPUS:0035687913

SN - 0012-3692

VL - 120

SP - 1861

EP - 1868

JO - CHEST

JF - CHEST

IS - 6

ER -

Correlates of peak expiratory flow lability in elderly persons

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