COPD: Epidemiology, Prevalence, Morbidity and Mortality, and Disease Heterogeneity

doi:10.1378/chest.121.5_suppl.121S

Chest

Volume 121, Issue 5, Supplement, May 2002, Pages 121S-126S

https://doi.org/10.1378/chest.121.5_suppl.121S Get rights and content

COPD continues to cause a heavy health and economic burden both in the United States and around the world. Some of the risk factors for COPD are well-known and include smoking, occupational exposures, air pollution, airway hyperresponsiveness, asthma, and certain genetic variations, although many questions, such as why < 20% of smokers develop significant airway obstruction, remain. Precise definitions of COPD vary and are frequently dependent on an accurate diagnosis of the problem by a physician. These differences in the definition of COPD can have large effects on the estimates of COPD in the population. Furthermore, evidence that COPD represents several different disease processes with potentially different interventions continues to emerge. In most of the world, COPD prevalence and mortality are still increasing and likely will continue to rise in response to increases in smoking, particularly by women and adolescents. Resources aimed at smoking cessation and prevention, COPD education and early detection, and better treatment will be of the most benefit in our continuing efforts against this important cause of morbidity and mortality. ^;126>

Section snippets

Definitions

Several different definitions exist for COPD. The American Thoracic Society (ATS) has defined COPD as “a disease state characterized by the presence of airflow limitation due to chronic bronchitis or emphysema; the airflow obstruction is generally progressive, may be accompanied by airway hyperreactivity, and may be partially reversible.”⁴ The European Respiratory Society (ERS) defined COPD as “reduced maximum expiratory flow and slow forced emptying of the lungs, which is slowly progressive

Conclusion

COPD is a common disease causing a great deal of morbidity and mortality both in the United States and worldwide. Current symptom-based definitions or clinically based definitions of COPD cause the underestimation of the prevalence of actual disease, and we may need to progress to a definition based on objective measurements. Furthermore, the importance of COPD in both deaths and hospitalizations is frequently underestimated. COPD is a systemic and heterogeneous disease, and certain aspects of

REFERENCES (41)

SI Rennard
COPD: overview of definitions, epidemiology, and factors influencing its development
Chest
(1998)
SS Hurd
International efforts directed at attacking the problem of COPD
Chest
(2000)
JT Chang et al.
COPD in the elderly: a reversible cause of functional impairment
Chest
(1995)
SD Sullivan et al.
The economic burden of COPD
Chest
(2000)
SI Rennard et al.
Smoking cessation
Chest
(2000)
EK Silverman et al.
Risk factors for the development of chronic obstructive pulmonary disease
Med Clin North Am
(1996)
CS Ulrik et al.
Mortality and markers of risk of asthma death among 1,075 outpatients with asthma
Chest
(1995)
P Piccioni et al.
Predictors of survival in a group of patients with chronic airflow obstruction
J Clin Epidemiol
(1998)
NM Siafakas et al.
Optimal assessment and management of chronic obstructive pulmonary disease (COPD): the European Respiratory Society Task Force
Eur Respir J
(1995)
American Thoracic Society
Standards for the diagnosis and care of patients with chronic obstructive pulmonary disease
Am J Respir Crit Care Med
(1995)

World Health Organization

The GOLD global strategy for the management and prevention of COPD

American Thoracic Society

Lung function testing: selection of reference values and interpretive strategies

Am Rev Respir Dis

(1991)

A Dirksen et al.

Bronchodilator and corticosteroid reversibility in ambulatory patients with airways obstruction

Dan Med Bull

(1991)

JC Bestall et al.

Usefulness of the Medical Research Council (MRC) dyspnoea scale as a measure of disability in patients with chronic obstructive pulmonary disease

Thorax

(1999)

AL Sheffer et al.

The National Asthma Education Program: expert panel report guidelines for the diagnosis and management of asthma; National Heart, Lung, and Blood Institute

Medical Care

(1993)

National Health Interview Survey

research for the 1995–2004 redesign

Vital Health Stat 2

(1999)

Centers for Disease Control and Prevention

Measuring childhood asthma prevalence before and after the 1997 redesign of the National Health Interview Survey: United States

MMWR Morb Mortal Wkly Rep

(2000)

Plan and operation of the Third National Health and Nutrition Examination Survey, 1988–94: series 1; programs and collection procedures

Vital Health Stat 1

(1994)

American Thoracic Society

Standardization of spirometry: 1987 update; statement of the American Thoracic Society

Am Rev Respir Dis

(1987)

RE Kanner et al.

Gender difference in airway hyperresponsiveness in smokers with mild COPD: the Lung Health Study

Am J Respir Crit Care Med

(1994)

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Chest

COPD: Epidemiology, Prevalence, Morbidity and Mortality, and Disease Heterogeneity

Section snippets

Definitions

Conclusion

Chest

Chest

Chest

Chest

Chest

Med Clin North Am

Chest

J Clin Epidemiol

Optimal assessment and management of chronic obstructive pulmonary disease (COPD): the European Respiratory Society Task Force

Eur Respir J

Standards for the diagnosis and care of patients with chronic obstructive pulmonary disease

Am J Respir Crit Care Med

The GOLD global strategy for the management and prevention of COPD

Lung function testing: selection of reference values and interpretive strategies

Am Rev Respir Dis

Bronchodilator and corticosteroid reversibility in ambulatory patients with airways obstruction

Dan Med Bull

Usefulness of the Medical Research Council (MRC) dyspnoea scale as a measure of disability in patients with chronic obstructive pulmonary disease

Thorax

The National Asthma Education Program: expert panel report guidelines for the diagnosis and management of asthma; National Heart, Lung, and Blood Institute

Medical Care

research for the 1995–2004 redesign

Vital Health Stat 2

Measuring childhood asthma prevalence before and after the 1997 redesign of the National Health Interview Survey: United States

MMWR Morb Mortal Wkly Rep

Plan and operation of the Third National Health and Nutrition Examination Survey, 1988–94: series 1; programs and collection procedures

Vital Health Stat 1

Standardization of spirometry: 1987 update; statement of the American Thoracic Society

Am Rev Respir Dis

Gender difference in airway hyperresponsiveness in smokers with mild COPD: the Lung Health Study

Am J Respir Crit Care Med