Chest
Volume 90, Issue 4, October 1986, Pages 480-484
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Clinical Investigations
A Prospective Study of the Natural History of Asthma: Remission and Relapse Rates

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In this longitudinal study of a general population sample, remissions of asthma were common only during the second decade of life and were especially unusual in subjects ages 30 to 60 years on enrollment. Asthmatic subjects with severe symptoms, with reduced ventilatory function, or with a concomitant diagnosis of chronic bronchitis or emphysema on entry to the study were very unlikely to be in remission nine years later. Relapses of disease were common in subjects with a past history of asthma who were considered to be quiescient on enrollment to the study. Relapse rates tended to increase with age, at least up to the age of 70. Relapses were especially frequent among those “ex-asthmatics” who had persisting respiratory symptomatology on entry to the study.

Section snippets

MATERIALS AND METHODS

The population under study is a random stratified cluster sample of non-Mexican white American households in Tucson, Ariz. Details of the selection of the population and general methods have been published.15 Initial self-completion questionnaires were obtained from 3, 454 subjects. The present study examined only those who completed questionnaires in the first (1972 to 1973) and seventh (1981 to 1983) surveys. Because the surveys take slightly longer than one year, the mean follow-up was 9.4

Remission of Asthma

Of the 2, 300 subjects in the study, 136 had active asthma in the first survey. In the seventh survey, 30 of these 136 subjects were in remission, a 22 percent remission rate.

Figure 1 shows the rate of remission of active asthma by the age of the subjects at entry into the study. The total number at risk for a remission in each decade of age is indicated at the bottom of Figure 1. The remission rate was highest in the group aged 10 to 19 years, with 65 percent (13/20) having a remission, and

DISCUSSION

In this study, a high remission rate (65 percent; 13/20) was noted only in the group aged 10 to 19 years. Previous studies have also shown this decade to be characterized by frequent remissions. Williams and McNicol and associates7, 8, 9, 10 prospectively studied 331 children from 7 to 21 years old who had asthma or wheezy bronchitis when enrolled. Remissions of at least one-year duration were noted in 70 to 75 percent of these children at the age of 14 years, and 55 percent of those who had a

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Supported by Specialized Center of Research grant HL-14136 from the National Heart Lung, and Blood Institute.

†American Thoracic Society/American Lung Association Research Training Fellowship awardee at the time of the study

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