You might think your lungs are fine if you don't have a classic breathing disease like COPD. But two other patterns on a breathing test—called PRISm and restrictive spirometry—are linked to a higher risk of dying, and we haven't known how common they are globally. A massive new review of data from over 1.1 million people across 31 countries gives us the first clear picture. It found that about 10.6% of people have PRISm, and about 12.1% have a restrictive pattern. Combined, that's roughly 1 in 10 adults walking around with one of these lung issues. The numbers aren't the same for everyone. Current smokers have a higher prevalence of PRISm than ex-smokers or non-smokers. The risk also climbs if you're older, have an extreme body weight, or have other health problems like asthma, diabetes, hypertension, or a history of stroke. The findings show these aren't rare quirks—they're widespread conditions tied to specific risks, which means doctors should consider them when checking lung health, especially in these higher-risk groups.
Meta-analysis: GOLD-PRISm prevalence 10.60%, GOLD-RSP 12.09% in general populationHow common are hidden lung problems? A global review finds about 1 in 10 adults may have them
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This systematic review and multi-level meta-analysis aimed to estimate the global prevalence and identify risk factors for preserved ratio impaired spirometry (PRISm) and restrictive spirometry pattern (RSP) in the general population. The analysis included 57 studies reporting population-based data from 31 countries, with 48 studies using the Global Initiative for Chronic Obstructive Lung Disease (GOLD) definition included in the meta-analysis, comprising a pooled sample of 1,129,807 participants. The primary outcome was the pooled prevalence of GOLD-defined PRISm (FEV1 <80% predicted with FEV1/FVC ≥0.7) and RSP (FVC <80% predicted with FEV1/FVC ≥0.7). The results showed a pooled prevalence of GOLD-PRISm of 10.60% (19 studies; 95% CI=8.12, 13.73) and a pooled prevalence of GOLD-RSP of 12.09% (23 studies; 95% CI=7.90, 18.04). The simultaneous combined prevalence of GOLD-PRISm and RSP was 11.79% (38 studies; 95% CI=9.11, 15.12). Subgroup analysis revealed higher GOLD-PRISm prevalence in current smokers (13.37%) compared to ex-smokers (10.18%) and non-smokers (10.87%), and in populations from the Western Pacific Region (11.26%). Significant risk factors identified for GOLD-PRISm included older adults, current and former smoking, extreme body mass index, and a history of comorbidities such as asthma, diabetes, hypertension, and stroke. The study concludes by highlighting significant regional and demographic variations in prevalence and noting that key risk factors, particularly smoking and comorbidities, should be considered for early management strategies.
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