Disease burden, comorbidities and antecedents of chronic cough phenotypes in Australian adults.

Sep 25, 2023

Experts: S Suresh,J L Perret,E H Walters,M J Abramson,G Bowatte,C Lodge,A Lowe,B Erbas,P Thomas,G S Hamilton,A B Chang,S C Dharmage,D S Bui

While adult chronic cough has high burden, its phenotypes, particularly those without aetiologically related underlying conditions, are understudied. We investigated the prevalence, lung function and comorbidities of adult chronic cough phenotypes.
Data from 3608 participants aged 53 years from the Tasmanian Longitudinal Health Study (TAHS) were included. Chronic cough was defined as cough on most days for >3 months in a year. Chronic cough was classified into “explained cough” if there were any one of four major cough-associated conditions (asthma, COPD, gastroesophageal reflux disease or rhinosinusitis) or “unexplained cough” if none were present. Adjusted regression analyses investigated associations between these chronic cough phenotypes, lung function and non-respiratory comorbidities at 53 years.
The prevalence of chronic cough was 10% (95%CI 9.1,11.0%) with 46.4% being “unexplained”. Participants with unexplained chronic cough had lower FEV/FVC (coefficient: -1.2% [95%CI:-2,3, -0.1]) and increased odds of comorbidities including obesity (OR=1.6 [95%CI: 1.2, 2.3]), depression (OR=1.4 [95%CI: 1.0, 2.1]), hypertension (OR=1.7 [95%CI: 1.2, 2.4]) and angina, heart attack or myocardial infarction to a lesser extent, compared to those without chronic cough. Participants with explained chronic cough also had lower lung function than both those with unexplained chronic cough and those without chronic cough.
Chronic cough is prevalent in middle-age and a high proportion is unexplained. Unexplained cough contributes to poor lung function and increased comorbidities. Given unexplained chronic cough is not a symptom of major underlying respiratory conditions it should be targeted for better understanding in both clinical settings and research.

Copyright © 2023 Sociedade Portuguesa de Pneumologia. Published by Elsevier España, S.L.U. All rights reserved.

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ABOUT THE EXPERTS

S Suresh,J L Perret,E H Walters,M J Abramson,G Bowatte,C Lodge,A Lowe,B Erbas,P Thomas,G S Hamilton,A B Chang,S C Dharmage,D S Bui

S Suresh

University of Melbourne Medical School, Parkville, Victoria, Australia; Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia.

J L Perret

Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia.

E H Walters

Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia; School of Medicine, University of Tasmania, Hobart, Tasmania, Australia.

M J Abramson

School of Public Health & Preventive Medicine, Monash University, Melbourne, Victoria, Australia.

G Bowatte

Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia.

C Lodge

Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia.

A Lowe

Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia.

B Erbas

School of Psychology & Public Health, La Trobe University, Bundoora, Victoria, Australia.

P Thomas

Prince of Wales’ Clinical School, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia.

G S Hamilton

Monash Lung, Sleep, Allergy and Immunology, Monash Health, Clayton, Australia; School of Clinical Sciences, Monash University, Clayton, Australia.

A B Chang

Dept of Respiratory and Sleep Medicine, Queensland Children’s Hospital, Brisbane, Queensland, Australia; NHMRC Centre for Research Excellence in Paediatric Bronchiectasis (AusBREATHE), Child Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia; Australian Centre for Health Services Innovation, Queensland University of Technology, Brisbane, Queensland, Australia.

S C Dharmage

Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia; NHMRC-CRE Centre for Air pollution, Energy and Health Research, Australia.

D S Bui

Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia.