Epidemiology Risk Factors and Natural History

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Key Points

  • Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality worldwide, and results in an economic and social burden that is both substantial and increasing.
  • Prevalence and morbidity data greatly underestimate the total burden of COPD because the disease is usually not diagnosed until it is clinically apparent and moderately advanced. See EPIDEMIOLOGY / PREVALENCE. See EPIDEMIOLOGY / MORBIDITY.
  • In people aged 25-75 yrs in the USA, the estimated prevalence of mild COPD (defined as forced expiratory volume in one second (FEV1)/forced vital capacity (FVC) <70% and FEV1 >80% predicted) was 6.9% and of moderate COPD (defined as FEV1/FVC <79% and FEV1 ≤80% predicted) was 6.6%, according to the National Health and Nutrition Examination Survey (NHANES). See REFERENCES.
  • COPD is the fourth leading cause of death in the USA and Europe, and COPD mortality in females has more than doubled over the last 20 yrs. See EPIDEMIOLOGY / MORTALITY.
  • COPD is a more costly disease than asthma and, depending on country, 50-75% of the costs are for services associated with exacerbations. See EPIDEMIOLOGY / ECONOMIC BURDEN.
  • Tobacco smoke is by far the most important risk factor for COPD worldwide. See RISK HOST FACTORS.
  • Other important risk factors are occupational exposures, socioeconomic status and genetic predisposition. See RISK EXPOSURES.

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