Global prevalence of dyspnoea: a systematic review and meta-analysis

BACKGROUND: Dyspnoea is a common subjective experience associated with decreased exercise tolerance and mortality. Although several studies have explored its prevalence in the general population, there has been limited synthesis over broad income settings, particularly low-income countries. This review and meta-analysis aims to address these gaps by reviewing the global prevalence of dyspnoea across low, middle, and high-income countries and associated factors. METHODS: A systematic review and meta-analysis were completed evaluating the prevalence of dyspnoea in the general population and associated factors including age, BMI, smoking status, underlying conditions, lung function indices and country of residence. The protocol followed PRISMA guidelines and was prospectively registered with PROSPERO (CRD42022374929). RESULTS: Of 13,504 records screened, 56 studies were included with a total of 450,520 participants. Using the mMRC Dyspnoea Scale, (n = 43), the pooled prevalence of dyspnoea was 22.2% [95% CI 17.5-27.2]. 6.1% [95% CI 4.3-8.2] reported moderate dyspnoea (mMRC 2), 2.5% [95% CI 1.5-3.6] described moderate-severe dyspnoea (mMRC 3), and 1.2% [95% CI 0.7-1.9] reported severe dyspnoea (mMRC 4). Women reported more dyspnoea than men (6.7% vs. 4.3%). Rates of dyspnoea were higher in North America than in Australia/New Zealand (29.4% vs. 19.6%). No clear differences were noted between low-income countries and high-income countries, although data were limited. CONCLUSIONS: This review demonstrates a high burden of dyspnoea, affecting one in five adults in the general global population. Dyspnoea prevalence was higher in women and there was significant geographical variation.