Exertional breathlessness related to medical conditions in middle-aged people: the population-based SCAPIS study of more than 25,000 men and women

Magnus Ekström, Josefin Sundh, Anders Andersson, Oskar Angerås, Anders Blomberg, Mats Börjesson, Kenneth Caidahl, Össur Ingi Emilsson, Jan Engvall, Erik Frykholm, Ludger Grote, Kristofer Hedman, Tomas Jernberg, Eva Lindberg, Andrei Malinovschi, André Nyberg, Eric Rullman, Jacob Sandberg, Magnus Sköld, Nikolai StenforsJohan Sundström, Hanan Tanash, Suneela Zaigham, Carl Johan Carlhäll

Research output: Contribution to journalArticlepeer-review


Background: Breathlessness is common in the population and can be related to a range of medical conditions. We aimed to evaluate the burden of breathlessness related to different medical conditions in a middle-aged population. Methods: Cross-sectional analysis of the population-based Swedish CArdioPulmonary bioImage Study of adults aged 50–64 years. Breathlessness (modified Medical Research Council [mMRC] ≥ 2) was evaluated in relation to self-reported symptoms, stress, depression; physician-diagnosed conditions; measured body mass index (BMI), spirometry, venous haemoglobin concentration, coronary artery calcification and stenosis [computer tomography (CT) angiography], and pulmonary emphysema (high-resolution CT). For each condition, the prevalence and breathlessness population attributable fraction (PAF) were calculated, overall and by sex, smoking history, and presence/absence of self-reported cardiorespiratory disease. Results: We included 25,948 people aged 57.5 ± [SD] 4.4; 51% women; 37% former and 12% current smokers; 43% overweight (BMI 25.0–29.9), 21% obese (BMI ≥ 30); 25% with respiratory disease, 14% depression, 9% cardiac disease, and 3% anemia. Breathlessness was present in 3.7%. Medical conditions most strongly related to the breathlessness prevalence were (PAF 95%CI): overweight and obesity (59.6–66.0%), stress (31.6–76.8%), respiratory disease (20.1–37.1%), depression (17.1–26.6%), cardiac disease (6.3–12.7%), anemia (0.8–3.3%), and peripheral arterial disease (0.3–0.8%). Stress was the main factor in women and current smokers. Conclusion: Breathlessness mainly relates to overweight/obesity and stress and to a lesser extent to comorbidities like respiratory, depressive, and cardiac disorders among middle-aged people in a high-income setting—supporting the importance of lifestyle interventions to reduce the burden of breathlessness in the population.

Original languageEnglish
Article number127
JournalRespiratory Research
Issue number1
Publication statusPublished - 2024 Dec

Subject classification (UKÄ)

  • Respiratory Medicine and Allergy

Free keywords

  • Diseases
  • Dyspnea
  • Epidemiology
  • Obesity


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