A comprehensive analysis of association of medical history with airflow limitation: a cross-sectional study.

Background: Multiple comorbidity is common and increases the complexity of the presentation of patients with COPD. This study was a comprehensive analysis of the relationship between a medical history of 22 disease categories and the presence of airflow limitation (AL) without any history of asthma or bronchiectasis, compatible with COPD.

Methods: A total of 11,898 Japanese patients aged ≥40 years, who underwent spirometry tests, comprising patients with AL (n=2,309) or without AL (n=9,589), were evaluated. Generalized estimating equations were used to assess the relationship between the presence of AL and each disease. The model was adjusted for age, sex, body mass index (BMI) and pack-years of smoking.

Results: In multivariate analysis, female sex (odds ratio [OR]: 0.59; 95% confidence interval [CI]: 0.52-0.67), age (OR for 10-year age increase: 1.99; CI: 1.90-2.09), BMI (OR for 1 kg/m increase: 0.96; CI: 0.95-0.98) and smoking history (<15 vs 15-24, 25-49 and ≥50 pack-years; OR: 1.78, 2.6 and 3.69, respectively; CI: 1.46-2.17, 2.24-3.0 and 3.15-4.33, respectively) were significantly associated with the presence of AL. In addition, a history of tuberculosis (OR: 1.72; CI: 1.39-2.11), primary lung cancer (OR: 1.50; CI: 1.28-1.77), myocardial infarction (OR: 1.22; CI: 1.01-1.48), heart failure (OR: 1.53; CI: 1.29-1.81), arrhythmia (OR: 1.19; CI: 1.03-1.38) or heart valve disorder (OR: 1.33; CI: 1.14-1.56) was significantly associated with the presence of AL, after adjustment.

Conclusion: This study suggests that a history of heart disease leading to abnormal cardiac function may be associated with AL and that the presence of certain types of heart disease provides a rationale to assess lung status and look for respiratory impairment, including COPD.