59
views
0
recommends
+1 Recommend
0 collections
    0
    shares
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      Chronic obstructive pulmonary disease mortality and prevalence: the associations with smoking and poverty—a BOLD analysis

      research-article
      1 , 1 , 1 , 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 1 , 14 , for the Burden of Obstructive Lung Disease (BOLD) Study
      (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab)
      Thorax
      BMJ Publishing Group
      COPD epidemiology, Tobacco and the lung, Lung Physiology

      Read this article at

      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Background

          Chronic obstructive pulmonary disease (COPD) is a commonly reported cause of death and associated with smoking. However, COPD mortality is high in poor countries with low smoking rates. Spirometric restriction predicts mortality better than airflow obstruction, suggesting that the prevalence of restriction could explain mortality rates attributed to COPD. We have studied associations between mortality from COPD and low lung function, and between both lung function and death rates and cigarette consumption and gross national income per capita (GNI).

          Methods

          National COPD mortality rates were regressed against the prevalence of airflow obstruction and spirometric restriction in 22 Burden of Obstructive Lung Disease (BOLD) study sites and against GNI, and national smoking prevalence. The prevalence of airflow obstruction and spirometric restriction in the BOLD sites were regressed against GNI and mean pack years smoked.

          Results

          National COPD mortality rates were more strongly associated with spirometric restriction in the BOLD sites (<60 years: men r s=0.73, p=0.0001; women r s=0.90, p<0.0001; 60+ years: men r s=0.63, p=0.0022; women r s=0.37, p=0.1) than obstruction (<60 years: men r s=0.28, p=0.20; women r s=0.17, p<0.46; 60+ years: men r s=0.28, p=0.23; women r s=0.22, p=0.33). Obstruction increased with mean pack years smoked, but COPD mortality fell with increased cigarette consumption and rose rapidly as GNI fell below US$15 000. Prevalence of restriction was not associated with smoking but also increased rapidly as GNI fell below US$15 000.

          Conclusions

          Smoking remains the single most important cause of obstruction but a high prevalence of restriction associated with poverty could explain the high ‘COPD’ mortality in poor countries.

          Related collections

          Most cited references20

          • Record: found
          • Abstract: found
          • Article: not found

          A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010

          The Lancet, 380(9859), 2224-2260
            Bookmark
            • Record: found
            • Abstract: found
            • Article: not found

            Chronic obstructive pulmonary disease in non-smokers.

            Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality worldwide. Tobacco smoking is established as a major risk factor, but emerging evidence suggests that other risk factors are important, especially in developing countries. An estimated 25-45% of patients with COPD have never smoked; the burden of non-smoking COPD is therefore much higher than previously believed. About 3 billion people, half the worldwide population, are exposed to smoke from biomass fuel compared with 1.01 billion people who smoke tobacco, which suggests that exposure to biomass smoke might be the biggest risk factor for COPD globally. We review the evidence for the association of COPD with biomass fuel, occupational exposure to dusts and gases, history of pulmonary tuberculosis, chronic asthma, respiratory-tract infections during childhood, outdoor air pollution, and poor socioeconomic status.
              Bookmark
              • Record: found
              • Abstract: found
              • Article: not found

              Mortality in COPD: Role of comorbidities.

              Chronic obstructive pulmonary disease (COPD) represents an increasing burden throughout the world. COPD-related mortality is probably underestimated because of the difficulties associated with identifying the precise cause of death. Respiratory failure is considered the major cause of death in advanced COPD. Comorbidities such as cardiovascular disease and lung cancer are also major causes and, in mild-to-moderate COPD, are the leading causes of mortality. The links between COPD and these conditions are not fully understood. However, a link through the inflammation pathway has been suggested, as persistent low-grade pulmonary and systemic inflammation, both known risk factors for cardiovascular disease and cancer, are present in COPD independent of cigarette smoking. Lung-specific measurements, such as forced expiratory volume in one second (FEV(1)), predict mortality in COPD and in the general population. However, composite tools, such as health-status measurements (e.g. St George's Respiratory Questionnaire) and the BODE index, which incorporates Body mass index, lung function (airflow Obstruction), Dyspnoea and Exercise capacity, predict mortality better than FEV(1) alone. These multidimensional tools may be more valuable because, unlike predictive approaches based on single parameters, they can reflect the range of comorbidities and the complexity of underlying mechanisms associated with COPD. The current paper reviews the role of comorbidities in chronic obstructive pulmonary disease mortality, the putative underlying pathogenic link between chronic obstructive pulmonary disease and comorbid conditions (i.e. inflammation), and the tools used to predict chronic obstructive pulmonary disease mortality.
                Bookmark

                Author and article information

                Journal
                Thorax
                Thorax
                thoraxjnl
                thorax
                Thorax
                BMJ Publishing Group (BMA House, Tavistock Square, London, WC1H 9JR )
                0040-6376
                1468-3296
                May 2014
                18 December 2013
                : 69
                : 5
                : 465-473
                Affiliations
                [1 ]National Heart & Lung Institute, Imperial College , London, UK
                [2 ]Department of Medical Sciences: Respiratory Medicine & Allergology, Uppsala University , Uppsala, Sweden
                [3 ]University of Kentucky , Lexington, Kentucky, USA
                [4 ]Jagiellonian University School of Medicine , Cracow, Poland
                [5 ]Department of Pulmonary Medicine, Paracelsus Medical University , Salzburg, Austria
                [6 ]University of British Columbia , Vancouver, British Columbia, Canada
                [7 ]University of Cape Town Lung Institute , Cape Town, South Africa
                [8 ]Cukurova University School of Medicine , Adana, Turkey
                [9 ]Kaiser Permanente Center for Health Research , Portland, Oregon, USA
                [10 ]Landspitali University Hospital , Reykjavik, Iceland
                [11 ]Woolcock Institute of Medical Research , Sydney, Australia
                [12 ]Sher-i-Kashmir Institute of Medical Sciences , Srinagar, Jammu and Kashmir, India
                [13 ]Faculté de Médecine, Sousse, Tunisia
                [14 ]Oregon Health & Sciences University , Portland, Oregon, USA
                Author notes
                [Correspondence to ] Professor Peter Burney, National Heart & Lung Institute, Imperial College, 1 Manresa Road, London SW3 6LR, UK; p.burney@ 123456imperial.ac.uk
                Article
                thoraxjnl-2013-204460
                10.1136/thoraxjnl-2013-204460
                3995258
                24353008
                71dc854f-f95a-4e9c-85e5-0b63a503665e
                Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions

                This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 3.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See: http://creativecommons.org/licenses/by/3.0/

                History
                : 2 September 2013
                : 20 November 2013
                : 22 November 2013
                Categories
                1506
                Respiratory Epidemiology
                Original article
                Custom metadata
                unlocked

                Surgery
                copd epidemiology,tobacco and the lung,lung physiology
                Surgery
                copd epidemiology, tobacco and the lung, lung physiology

                Comments

                Comment on this article