Significant bronchodilator responsiveness and "reversibility" in a population sample

Heather A. Prentice, David M. Mannino, Glyn G. Caldwell, Heather M. Bush

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10 Scopus citations


Chronic Obstructive Pulmonary Disease (COPD) is defined by being "not fully reversible", most guidelines recommend measurement of lung function after the administration of a bronchodilator. The objective of this study was to compare bronchodilator responsiveness (significant improvement in the FEV 1 or FVC) to full-, partial- or "inverse'" reversibility in obstruction status in a population-based sample in Southeastern Kentucky. The study population was selected using random digit dialing of an adult population in Southeastern Kentucky as part of the Burden of Lung disease (BOLD) project. Lung function was assessed using spirometry pre- and post-bronchodilation. Subjects presence and severity of COPD was classified using modified Global Obstructive Lung Disease (GOLD) criteria. We examined the relation between changes in "obstruction" status (based on the FEV1/ FVC of 0.7) and the presence of "significant bronchodilator responsiveness" (based on ≥ 12 improvement in the FEV1 or the FVC). The final population with acceptable pre- and post-bronchodilator spirometry included 440 participants. 32/440 subjects (7.3%) changed from obstructed to unobstructed (full-reversibility), 19/440 (4.3%) changed from unobstructed to obstructed ("inverse"-reversibility), 389/440 (88.4%) had either no-change or partial-reversibility, and 65/440 (14.8%) had bronchodilator responsiveness. Among those with full-reversibility, only 9/32 (28.1%) had bronchodilator responsiveness, whereas among subjects with "inverse"-reversibility, 10/19 (52.6%) had bronchodilator responsiveness. Among all subjects with bronchodilator responsiveness, only 19/65 (29.2%) changed categories. Our findings suggest that significant bronchodilator responsiveness is not the same as "reversibility" of "obstruction", even though these terms are often used interchangeably.

Original languageEnglish
Pages (from-to)323-330
Number of pages8
JournalCOPD: Journal of Chronic Obstructive Pulmonary Disease
Issue number5
StatePublished - Sep 2010

Bibliographical note

Funding Information:
David M. Mannino has served on advisory boards for Boehringer Ingelheim, Pfizer, GlaxoSmithKline, Sepracor, Astra-Zeneca, Novartis and Ortho Biotech and has received research grants from Astra-Zeneca, GlaxoSmithKline, Novartis and Pfizer. Heather A. Prentice, Glyn G. Caldwell, and Heather M. Bush report no conflicts of interest. The authors alone are responsible for the content and writing of this paper.


  • COPD
  • Definitions
  • Responsiveness
  • Reversibility

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine


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