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Research ArticleOriginal Research

Performance of Maximum Inspiratory Pressure Tests and Maximum Inspiratory Pressure Reference Equations for 4 Race/Ethnic Groups

Michael C Sachs, Paul L Enright, Karen D Hinckley Stukovsky, Rui Jiang and R Graham Barr
Respiratory Care October 2009, 54 (10) 1321-1328;
Michael C Sachs
Department of Biostatistics, University of Washington, Seattle, Washington.
MD
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Paul L Enright
Respiratory Science Center, College of Medicine, University of Arizona, Tucson, Arizona, and with the Division of Respiratory Disease Studies, National Institute of Occupational Safety and Health, Centers for Disease Control and Prevention, Atlanta, Georgia.
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Karen D Hinckley Stukovsky
Department of Biostatistics, University of Washington, Seattle, Washington.
MSc
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Rui Jiang
Department of Medicine, College of Physicians and Surgeons, Columbia University Medical Center, New York, New York.
MD DrPH
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R Graham Barr
Department of Medicine, College of Physicians and Surgeons, Columbia University Medical Center, New York, New York.
MD DrPH
Roles: for the Multi-Ethnic Study of Atherosclerosis Lung Study
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  • For correspondence: [email protected]
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Abstract

BACKGROUND: Maximum inspiratory pressure (MIP) is an important and noninvasive index of diaphragm strength and an independent predictor of all-cause mortality. The ability of adults over a wide age range and multiple race/ethnicities to perform MIP tests has previously not been evaluated.

METHODS: The Multi-Ethnic Study of Atherosclerosis recruited white, African American, Hispanic, and Chinese American participants, ages 45-84 years, and free of clinical cardiovascular disease in 6 United States cities. MIP was measured using standard techniques among 3,849 Multi-Ethnic Study of Atherosclerosis participants. The MIP quality goal was 5 maneuvers, with the 2 largest values matching within 10 cm H2O. Correlates of MIP quality and values were assessed in logistic and linear regression models.

RESULTS: The 3,849 participants with MIP measures were 51 female, 35% white, 26% African American, 23% Hispanic, and 16% Chinese American. Mean ± SD MIP was 73 ± 26 cm H2O for women and 97 ± 29 cm H2O for men. The quality goal was achieved by 83% of the cohort and was associated with female sex, older age, race/ethnicity, study site, low ratio of forced expiratory volume in the first second to forced vital capacity (FEV1/FVC), and wheeze with dyspnea. The multivariate correlates of MIP were male sex, younger age, higher body mass index, shorter height, higher FVC, higher systolic blood pressure (in women) and health status (in men). There were no clinically important race/ethnic differences in MIP values.

CONCLUSIONS: Race-specific reference equations for MIP are unnecessary in the United States. More than 80% of adults can be successfully coached for 5 maneuvers, with repeatability within 10 cm H2O.

  • diaphragm strength
  • respiratory muscle strength
  • maximum inspiratory pressure
  • quality control
  • pulmonary function testing

Footnotes

  • Correspondence: R Graham Barr MD DrPH, Columbia University Medical Center, 630 West 168th Street, PH 9 East, Room 105, New York NY 10032. E-mail: rgb9{at}columbia.edu.
  • This research was partly funded by National Heart, Lung, and Blood Institute contracts N01-HC-95159 through N01-HC-95165, N01-HC95169, and grant R01-HL077612. A full list of participating the Multi-Ethnic Study of Atherosclerosis (MESA) investigators and institutions can be found at http://www.mesa-nhlbi.org. This manuscript has been reviewed by the MESA Investigators for scientific content and consistency of data interpretation with previous MESA publications and important comments have been incorporated prior to submission for publication.

  • Copyright © 2009 by Daedalus Enterprises Inc.
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Respiratory Care: 54 (10)
Respiratory Care
Vol. 54, Issue 10
1 Oct 2009
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Performance of Maximum Inspiratory Pressure Tests and Maximum Inspiratory Pressure Reference Equations for 4 Race/Ethnic Groups
Michael C Sachs, Paul L Enright, Karen D Hinckley Stukovsky, Rui Jiang, R Graham Barr
Respiratory Care Oct 2009, 54 (10) 1321-1328;

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Performance of Maximum Inspiratory Pressure Tests and Maximum Inspiratory Pressure Reference Equations for 4 Race/Ethnic Groups
Michael C Sachs, Paul L Enright, Karen D Hinckley Stukovsky, Rui Jiang, R Graham Barr
Respiratory Care Oct 2009, 54 (10) 1321-1328;
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Keywords

  • diaphragm strength
  • respiratory muscle strength
  • maximum inspiratory pressure
  • quality control
  • pulmonary function testing

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