title: Lower bronchodilator responsiveness in Puerto Rican than in Mexican subjects with asthma.
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 beta2-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.
authors: University of California, San Francisco, 94143-0833, USA. eburch@itsa.ucsf.edu
authors: Esteban González
authors: EG
authors: Burchard
authors: Pedro C
authors: PC
authors: Avila
authors: Sylvette
authors: S
authors: Nazario
authors: Jesus
authors: J
authors: Casal
authors: Alfonso
authors: A
authors: Torres
authors: Jose R
authors: JR
authors: Rodriguez-Santana
authors: Monica
authors: M
authors: Toscano
authors: Jody Senter
authors: JS
authors: Sylvia
authors: MariaElena
authors: M
authors: Alioto
authors: Michael
authors: M
authors: Salazar
authors: Ivan
authors: I
authors: Gomez
authors: Joanne K
authors: JK
authors: Fagan
authors: Jorge
authors: J
authors: Salas
authors: Craig
authors: C
authors: Lilly
authors: Henry
authors: H
authors: Matallana
authors: Elad
authors: E
authors: Ziv
authors: Richard
authors: R
authors: Castro
authors: Moises
authors: M
authors: Selman
authors: Rocio
authors: R
authors: Chapela
authors: Dean
authors: D
authors: Sheppard
authors: Scott T
authors: ST
authors: Weiss
authors: Jean G
authors: JG
authors: Ford
authors: Homer A
authors: HA
authors: Boushey
authors: William
authors: W
authors: Rodriguez-Cintron
authors: Jeffrey M
authors: JM
authors: Drazen
authors: Edwin K
authors: EK
authors: Silverman
mesh_terms: D001249:Asthma / Q000175:diagnosis / Q000188:drug therapy* / Q000208:ethnology*; D001985:Bronchial Provocation Tests; D001993:Bronchodilator Agents / Q000627:therapeutic use*; D015331:Cohort Studies; D005260:Female; D006630:Hispanic or Latino; D006801:Humans; D016014:Linear Models; D016015:Logistic Models; D008297:Male; D017058:Mexican Americans; D011336:Probability; D011379:Prognosis; D012129:Respiratory Function Tests; D018570:Risk Assessment; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology
chemical_list: D001993:Bronchodilator Agents