Lower Bronchodilator Responsiveness in Puerto Rican than in Mexican Subjects with Asthma

Esteban González Burchard*, Pedro C. Avila, Sylvette Nazario, Jesus Casal, Alfonso Torres, Jose R. Rodriguez-Santana, Monica Toscano, Jody Senter Sylvia, Maria Elena Alioto, Michael Salazar, Ivan Gomez, Joanne K. Fagan, Jorge Salas, Craig Lilly, Henry Matallana, Elad Ziv, Richard Castro, Moises Selman, Rocio Chapela, Dean SheppardScott T. Weiss, Jean G. Ford, Homer A. Boushey, William Rodriguez-Cintron, Jeffrey M. Drazen, Edwin K. Silverman

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

155 Scopus citations

Abstract

In the United States, Puerto Ricans and Mexicans have the highest and lowest asthma prevalence, morbidity, and mortality, respectively. To determine whether ethnicity-specific differences in therapeutic response, clinical response, and/or genetic factors contribute to differences in asthma outcomes, we compared asthma-related clinical characteristics among 684 Mexican and Puerto Rican individuals with asthma recruited from San Francisco, New York City, Puerto Rico, and Mexico City. Puerto Ricans with asthma had reduced lung function, greater morbidity, and longer asthma duration than did Mexicans with asthma. Bronchodilator responsiveness, measured as percentage change from baseline FEV1, was significantly lower among Puerto Ricans with asthma than among Mexicans with asthma. Puerto Ricans with asthma had on average 7.3% (95% confidence interval [CI], 4.6 to 9.9; p < 0.001) lower bronchodilator reversibility in FEV1, higher risk of an emergency department visit in the previous year (odds ratio, 2.63; 95% CI, 1.6 to 4.3; p < 0.001), and of previous hospitalization for asthma (odds ratio, 1.94; 95% CI, 1.2 to 3.2; p = 0.009) than Mexicans. Subgroup analysis corroborated that Puerto Ricans with asthma had more severe disease than did Mexicans on the basis of lung function measurements, responsiveness to β 2-adrenergic agonists, and health care use. We conclude that Puerto Ricans with asthma respond less to albuterol than do Mexicans with asthma. These findings underscore the need for additional research on racial/ethnic differences in asthma morbidity and response to therapy.

Original languageEnglish (US)
Pages (from-to)386-392
Number of pages7
JournalAmerican journal of respiratory and critical care medicine
Volume169
Issue number3
DOIs
StatePublished - Feb 1 2004

Keywords

  • Asthma
  • Bronchodilator
  • Clinical characteristics
  • Mexicans and Puerto Ricans

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine
  • Pulmonary and Respiratory Medicine

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