ArticleThe British journal of general practice : the journal of the Royal College of General Practitioners2020
Prognostic value of first-recorded breathlessness for future chronic respiratory and heart disease: a cohort study using a UK national primary care database.
Article in The British journal of general practice : the journal of the Royal College of General Practitioners, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed, 11 citations in OpenAlex.
- Investigating a structured diagnostic approach for chronic breathlessness in primary care: a mixed-methods feasibility cluster randomised controlled trial.BMJ open respiratory research · 2025Trial
- Prevalence of loneliness and its associated factors in middle-aged and older adults with breathlessness: a nationally representative cohort study.BMJ open respiratory research · 2026Article
- Ethnic differences in healthcare utilisation and diagnosis after first presentation with breathlessness: a retrospective cohort study using UK primary care records.NPJ primary care respiratory medicine · 2026Article
- Breathlessness intensity recorded in general practice is associated with shorter times to unplanned hospital admissions and longer lengths of stay: a UK cohort study.BMJ open respiratory research · 2025Article
- Comparing research recruitment strategies to prospectively identify patients presenting with breathlessness in primary care.NPJ primary care respiratory medicine · 2022Article
- Breathless and awaiting diagnosis in UK lockdown for COVID-19…We're stuck.NPJ primary care respiratory medicine · 2021Article
- Respiratory symptoms and respiratory deaths: A multi-cohort study with 45 years observation time.PloS one · 2021Article
- The association between comorbidity and physical activity levels in people with osteoarthritis: Secondary analysis from two randomised controlled trials.Osteoarthritis and cartilage open · 2020Article
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Authors and funding
7 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundBreathlessness is a common presentation in primary care.
aimTo assess the long-term risk of diagnosed chronic obstructive pulmonary disease (COPD), asthma, ischaemic heart disease (IHD), and early mortality in patients with undiagnosed breathlessness. DESIGN AND
settingMatched cohort study using data from the UK Clinical Practice Research Datalink.
methodAdults with first-recorded breathlessness between 1997 and 2010 and no prior diagnostic or prescription record for IHD or a respiratory disease ('exposed' cohort) were matched to individuals with no record of breathlessness ('unexposed' cohort). Analyses were adjusted for sociodemographic and comorbidity characteristics.
resultsIn total, 75 698 patients (the exposed cohort) were followed for a median of 6.1 years, and more than one-third subsequently received a diagnosis of COPD, asthma, or IHD. In those who remained undiagnosed after 6 months, there were increased long-term risks of all three diagnoses compared with those in the unexposed cohort. Adjusted hazard ratios for COPD ranged from 8.6 (95% confidence interval [CI] = 6.8 to 11.0) for >6-12 months after the index date to 2.8 (95% CI = 2.6 to 3.0) for >36 months after the index date; asthma, 11.7 (CI = 9.4 to 14.6) to 4.3 (CI = 3.9 to 4.6); and IHD, 3.0 (CI = 2.7 to 3.4) to 1.6 (CI = 1.5 to 1.7). Risk of a longer time to diagnosis remained higher in members of the exposed cohort who had no relevant prescription in the first 6 months; approximately half of all future diagnoses were made for such patients. Risk of early mortality (all cause and disease specific) was higher in members of the exposed cohort.
conclusionBreathlessness can be an indicator of developing COPD, asthma, and IHD, and is associated with early mortality. With careful assessment, appropriate intervention, and proactive follow-up and monitoring, there is the potential to improve identification at first presentation in primary care in those at high risk of future disease who present with this symptom.
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