COPD (Chronic Obstructive Pulmonary Disease)

What is COPD?

Chronic Obstructive Pulmonary Disease, or COPD, refers to a group of diseases that cause airflow blockage and breathing-related problems. It includes emphysema, chronic bronchitis, and in some cases asthma.

What causes COPD?

In the United States, tobacco smoke is a key factor in the development and progression of COPD,1 although exposure to air pollutants in the home and workplace, genetic factors, and respiratory infections also play a role. In the developing world, indoor air quality is thought to play a larger role in the development and progression of COPD than it does in the United States.

Who has COPD?

Chronic lower respiratory disease, primarily COPD, was the third leading cause of death in the United States in 2014.2 Almost 15.7 million Americans (6.4%) reported that they have been diagnosed with COPD.3 More than 50% of adults with low pulmonary function were not aware that they had COPD,4 so the actual number may be higher. The following groups were more likely to report COPD in 2013.3

• People aged 65–74 years and ≥ 75 years.
• American Indian/Alaska Natives and multiracial non-Hispanics.
• Women.
• Individuals who were unemployed, retired, or unable to work.
• Individuals with less than a high school education.
• Individuals who were divorced, widowed, or separated.
• Current or former smokers.
• People with a history of asthma.

What are the complications or effects of COPD?

Compared to adults without COPD, adults with COPD are more likely to

• Have activity limitations such as difficulty walking or climbing stairs.
• Be unable to work.
• Need special equipment such as portable oxygen tanks.
• Not engage in social activities such as eating out, going to places of worship, going to group events, or getting together with friends or neighbors.
• Have increased confusion or memory loss.
• Have more emergency room visits or overnight hospital stays.
• Have other chronic diseases such as arthritis, congestive heart failure, diabetes, coronary heart disease, stroke, or asthma.
• Have depression or other mental or emotional conditions.
• Report a fair or poor health status.9

How can COPD be prevented?

Avoid inhaling tobacco smoke, home and workplace air pollutants, and respiratory infections to prevent developing COPD. Early detection of COPD might change its course and progress. A simple test, called spirometry, can be used to measure pulmonary—or lung—function and detect COPD in anyone with breathing problems.

How is COPD treated?

Treatment of COPD requires a careful and thorough evaluation by a physician. COPD treatment can alleviate symptoms, decrease the frequency and severity of exacerbations, and increase exercise tolerance. For those who smoke, the most important aspect of treatment is smoking cessation. Avoiding tobacco smoke and removing other air pollutants from the patient’s home or workplace are also important. Symptoms such as coughing or wheezing can be treated with medication. Pulmonary rehabilitation is an individualized treatment program that teaches COPD management strategies to increase quality of life. Plans may include breathing strategies, energy-conserving techniques, exercise training, and nutritional counseling. Lung infections can cause serious problems in people with COPD. Certain vaccines, such as flu and pneumococcal vaccines, are especially important for people with COPD. Learn more about vaccination recommendations. Respiratory infections should be treated with antibiotics, if appropriate. Patients who have low blood oxygen levels are often given supplemental oxygen.

References

1. Centers for Disease Control and Prevention. Annual smoking-attributable mortality, years of potential life lost, and productivity losses—United States, 1997–2001. MMWR. 2005;54(250):625-628.
2. National Center for Health Statistics. Health, United States 2015 with Special Feature on Racial and Ethnic Health Disparities. Hyattsville, MD: US Dept. Health and Human Services; 2016. (http://www.cdc.gov/nchs/hus/) Accessed June 2016.
3. Wheaton AG, Cunningham, TJ, Ford ES, Croft JB. Employment and activity limitations among adults with chronic obstructive pulmonary disease—United States, 2013. MMWR. 2015:64 (11):290-295.
4. Mannino DM, Gagnon RC, Petty TL, Lydick E. Obstructive lung disease and low lung function in adults in the United States: data from the National Health and Nutrition Examination Survey 1988-1994. Arch Intern Med. 2000;160:1683-1689.
5. Greenlund KJ, Liu Y, Deokar AJ, Wheaton AG, Croft JB. Association of chronic obstructive pulmonary disease with increased confusion or memory loss and functional limitations among adults in 21 states, 2011 Behavioral Risk Factor Surveillance System. Prev Chronic Dis. 2016;13:150428.
6. Liu Y, Croft JB, Anderson LA, Wheaton AG, Presley-Cantrell LR, Ford ES. The association of chronic obstructive pulmonary disease, disability, engagement in social activities, and mortality among US adults aged 70 years or older: 1994-2006. Int J COPD. 2014;9:75-83.
7. Wheaton AG, Ford ES, Cunningham TJ, Croft JB. Chronic obstructive pulmonary disease, hospital visits, and comorbidities—National Survey of Residential Care Facilities, 2010. J Aging Health. 2015;27:480-499.
8. Cunningham TJ, Ford ES, Rolle IV, Wheaton AG, Croft JB. Association of self-reported cigarette smoking with chronic obstructive pulmonary disease and co-morbid chronic conditions in the United States. COPD. 2015;12;276-286.
9. Wheaton AG, Ford ES, Thompson WW, Greenlund KJ, Presley-Cantrell LR, Croft JB. Pulmonary function, chronic respiratory symptoms, and health-related quality of life among adults in the United States—National Health and Nutrition Examination Survey 2007-2010. BMC Public Health. 2013;13:854.
10. Qaseem A, Wilt TJ, Weinberger SE, et al. Diagnosis and management of stable chronic obstructive pulmonary disease: a clinical practice guideline update from the American College of Physicians, American College of Chest Physicians, American Thoracic Society, and European Respiratory Society. Annals Intern Med. 2011;155:179-191.