Respiratory symptoms in young adults and future lung disease the cardia lung study

Ravi Kalhan, Mark T. Dransfield, Laura A. Colangelo, Michael J. Cuttica, David R. Jacobs, Bharat Thyagarajan, Raul San Jose Estepar, Rola Harmouche, Jorge Onieva Onieva, Samuel Y. Ash, Yuka Okajima, Carlos Iribarren, Stephen Sidney, Cora E. Lewis, David M. Mannino, Kiang Liu, Lewis J. Smith, George R. Washko

Research output: Contribution to journalArticlepeer-review

66 Scopus citations


Rationale: There are limited data on factors in young adulthood that predict future lung disease. Objectives: To determine the relationship between respiratory symptoms, loss of lung health, and incident respiratory disease in a population-based study of young adults. Methods:Weexamined prospective data from2,749 participants in the CARDIA (Coronary Artery Risk Development in Young Adults) study who completed respiratory symptom questionnaires at baseline and 2 years later and repeated spirometry measurements over 30 years. Measurements and Main Results: Cough or phlegm, episodes of bronchitis, wheeze, shortness of breath, and chest illnesses at both baseline and Year 2 were the main predictor variables in models assessing decline in FEV1 and FVC from Year 5 to Year 30, incident obstructive and restrictive lung physiology, and visual emphysema on thoracic computed tomography scan. After adjustment for covariates, including body mass index, asthma, and smoking, report of any symptom was associated with22.71 ml/yr excess decline in FEV1 (P, 0.001) and22.18 in FVC (P,0.001) aswell as greater odds of incident (prebronchodilator) obstructive (odds ratio [OR], 1.63; 95% confidence interval [CI], 1.24-2.14) and restrictive (OR, 1.40; 95% CI, 1.09-1.80) physiology. Cough-related symptoms (OR, 1.56; 95% CI, 1.13-2.16) were associated with greater odds of future emphysema. Conclusions: Persistent respiratory symptoms in young adults are associated with accelerated decline in lung function, incident obstructive and restrictive physiology, and greater odds of future radiographic emphysema.

Original languageEnglish (US)
Pages (from-to)1616-1624
Number of pages9
JournalAmerican journal of respiratory and critical care medicine
Issue number12
StatePublished - Jun 15 2018

Bibliographical note

Publisher Copyright:
Copyright © 2018 by the American Thoracic Society.


  • Chronic obstructive pulmonary disease
  • Respiratory epidemiology
  • Respiratory function tests
  • Respiratory symptoms


Dive into the research topics of 'Respiratory symptoms in young adults and future lung disease the cardia lung study'. Together they form a unique fingerprint.

Cite this