PFLPhysiological Fitness Landscape

Biomarkers · Functional Fitness

Peak Expiratory Flow (PEF)

Higher values go with lower risk of death. Not measured in our NHANES panel. The curve is drawn from the published study (source below).

PEF and risk of death

Published curve higher than the NHANES fitNHANES fit higher

Risk of death relative to the curve's reference value, drawn from the published study (source below).

Published risk of death1.27×per 100 liters/minute DECREASE in peak flow rate (proportional risks of death, age/sex/smoking… (95% CI 1.19–1.36) · All community-dwelling elderly aged 65+ in East Boston, Massachusetts (1982-1983 survey), 3,582 with peak flow measured

PEF across cohorts

0.670.750.80.91HR per SD (95% CI)
HRS · United States, 50+24,145 people · 8,475 deaths0.56 0.54–0.59
CHARLS · China, 50+10,112 people · 1,619 deaths0.69 0.63–0.76
Risk-of-death ratio per standard deviation, adjusted for age and sex, within each cohort. Cohorts differ in age range, assay, measurement protocol and follow-up, and one SD is a different amount in each, so the comparison is of direction and rough size per SD, not per unit. Vertical line: no association.

PEF by age and sex

Each bar runs from the 5th to the 95th percentile, the darker part from the 25th to the 75th, and the tick is the median. Not a reference range or a target.

The percentiles as a table
Each row is one sex and age band: the values below which 5%, 25%, 50%, 75% and 95% of people fall (L/min), from the survey named in the row. Not a reference range or a target.
SexAge5th25thMedian75th95thnCycle / source
All20-393544545336357491,623NHANES 2011-2012
All40-592984094835867201,478NHANES 2011-2012
All60-792343334155146661,044NHANES 2011-2012
Allall2904094925987304,145NHANES 2011-2012
Men20-39445555630689788866NHANES 2011-2012
Men40-59374505585659756717NHANES 2011-2012
Men60-79272426519602706526NHANES 2011-2012
Menall3605115926657642,109NHANES 2011-2012
Women20-39325410459510582757NHANES 2011-2012
Women40-59263370423474563761NHANES 2011-2012
Women60-79216307359417476518NHANES 2011-2012
Womenall2603644264775612,036NHANES 2011-2012

What studies found when this marker was changed

They describe what happened in those study groups, not a recommendation. See all catalogued interventions.

Measured changes in PEF, study by study

4 effects with a numeric size, each from one study arm: the dot is the reported change, the line its 95% interval where one was given. Green points move the marker the way lower risk of death lies; amber the other way. Study results in the groups studied, not predictions for a person.

Each row is one study: what was changed, the effect it reported on this marker, and the source.
TypeInterventionReported effectEvidenceSource
exerciseStructured inspiratory and/or expiratory muscle training in stroke survivorsPEF increased by 0.51 L/s (95% CI 0.10-0.92) after respiratory muscle trainingmeta-analysisMenezes KK, Nascimento LR, Avelino PR, et al. Efficacy of Interventions to…
pharmacologicOral PDE4 inhibitor (roflumilast or cilomilast) added to standard therapy in moderate-to-very-severe COPD for 6 weeks to 1 yearPEF improved by 6.54 L/min (95% CI 3.95-9.13) over a mean of 40 weeks vs placebo (low-certainty evidence)meta-analysisJanjua S, Fortescue R, Poole P. Phosphodiesterase-4 inhibitors for chronic…
pharmacologicOral GB001 20 mg once daily for 16 weeks during inhaled corticosteroid taper/withdrawal in adults with mild-to-moderate asthmaMorning PEF improved by 13.7 L/min (95% CI 1.5-25.8) vs placebo with 20 mg (5 mg: 15.2 L/min, 95% CI 3.1-27.4)RCTAsano K, Sagara H, Ichinose M, et al. A Phase 2a Study of DP2 Antagonist GB001…
pharmacologicInhaled salmeterol 50 micrograms twice daily for one month added to inhaled corticosteroids in symptomatic children aged 5-14Mean morning PEF 9.6 L/min higher (95% CI 2.1-17.1) with salmeterol 50 mcg bd than salbutamol 200 mcg qds; 100 mcg bd: +13.8 L/min (6.0-21.5)RCTByrnes C, Shrewsbury S, Barnes PJ, et al. Salmeterol in paediatric asthma…

Sources

Map Peak Expiratory Flow (PEF) against another biomarker.

Related markers: Cardiorespiratory Fitness (VO2 Max) · Chronotropic Index · Daily Movement (Wrist Accelerometer, MIMS) · Daily Step Count · Exercise Capacity (METs) · FEV1/FEV6 Ratio · Forced Expiratory Volume in 1 Second (FEV1) · Forced Vital Capacity (FVC)

Map PEF against another marker