The number of deaths is projected to increase further because of continued exposure to risk factors and an aging population. In 2019 it caused 3.2 million deaths, 80% occurring in lower and middle income countries, up from 2.4 million deaths in 1990. It typically occurs in males and females over the age of 35–40. Īs of 2015, COPD affected about 174.5 million people (2.4% of the global population). In those who have periods of acute worsening, increased use of medications, antibiotics, corticosteroids and hospitalization may be needed. Some people may benefit from long-term oxygen therapy, lung volume reduction and lung transplantation. COPD treatments include smoking cessation, vaccinations, pulmonary rehabilitation, inhaled bronchodilators and corticosteroids. While treatment can slow worsening, there is no conclusive evidence that any medications can change the long-term decline in lung function.
Most cases of COPD can be prevented by reducing exposure to risk factors such as smoking and indoor and outdoor pollutants. The diagnosis is based on poor airflow as measured by spirometry.
In developing countries, common sources of indoor air pollution are the use of coal and biomass such as wood and dry dung as fuel for cooking and heating. Other risk factors include indoor and outdoor air pollution including dust, exposure to occupational irritants such as dust from grains, cadmium dust or fumes, and genetics, such as alpha-1 antitrypsin deficiency. The most common cause of COPD is tobacco smoking. COPD is associated with low-grade systemic inflammation. COPD and asthma may coexist and converge in some individuals. Emphysema and chronic bronchitis remain the predominant phenotypes of COPD but there is often overlap between them and a number of other phenotypes have also been described. Many definitions of COPD in the past included emphysema and chronic bronchitis, but these have never been included in GOLD report definitions. Chronic bronchitis does not always result in airflow limitation but in young adults with chronic bronchitis who smoke, the risk of developing COPD is high. Emphysema is just one of the structural abnormalities that can limit airflow and can exist without airflow limitation in a significant number of people. Both of these conditions can exist without airflow limitation when they are not classed as COPD. Chronic bronchitis is defined as a productive cough that is present for at least three months each year for two years. Įmphysema is defined as enlarged airspaces ( alveoli) whose walls have broken down resulting in permanent damage to the lung tissue. However, this basic dogma has been challenged as varying degrees of co-existing emphysema, chronic bronchitis, and potentially significant vascular diseases have all been acknowledged in those with COPD, giving rise to the classification of other phenotypes or subtypes. The two most common types of COPD are emphysema and chronic bronchitis and have been the two classic COPD phenotypes. While COPD is incurable, it is preventable and treatable. COPD progressively worsens, with everyday activities such as walking or dressing becoming difficult. The main symptoms of COPD include shortness of breath and a cough, which may or may not produce mucus. GOLD 2024 defined COPD as a heterogeneous lung condition characterized by chronic respiratory symptoms (dyspnea, cough, sputum production and/or exacerbations) due to abnormalities of the airways (bronchitis, bronchiolitis) and/or alveoli (emphysema) that cause persistent, often progressive, airflow obstruction. Pulmonary rehabilitation, long-term oxygen therapy, lung volume reduction, Ĭhronic obstructive pulmonary disease ( COPD) is a type of progressive lung disease characterized by long-term respiratory symptoms and airflow limitation. Stopping smoking, improving indoor and outdoor air quality, tobacco control measures Tobacco smoking, air pollution, genetics Īsthma, congestive heart failure, bronchiectasis, tuberculosis, obliterative bronchiolitis, diffuse panbronchiolitis Section of a lung showing centrilobular emphysema, with enlarged airspaces in the centre of a lobule usually caused by smoking and a major feature of COPDĪnxiety, depression, pulmonary heart disease, pneumothorax Medical condition Chronic obstructive pulmonary diseaseĬhronic obstructive lung disease (COLD), chronic obstructive airway disease (COAD)