CHRONIC OBSTRUCTIVE PULMONARY DISEASE

Developing COPD: a 25 year follow up study of the general population

A Løkke¹, P Lange^1,2, H Scharling², P Fabricius¹, J Vestbo^1,3

¹ Department of Cardiology and Respiratory Medicine, Hvidovre Hospital, Hvidovre, Denmark
² The Copenhagen City Heart Study, Bispebjerg Hospital, Copenhagen, Denmark
³ North West Lung Centre, South Manchester University Hospital Trust, Manchester, UK

Correspondence to:
Correspondence to:
Dr P Lange
Department of Cardiology and Respiratory Medicine, 253 Hvidovre Hospital, Kettegård Alle 30, DK-2650 Hvidovre, Denmark; peter.lange{at}hh.hosp.dk

Background: Smokers are more prone to develop chronic obstructive pulmonary disease (COPD) than non-smokers, but this finding comes from studies spanning 10 years or less. The aim of this study was to determine the 25 year absolute risk of developing COPD in men and women from the general population.

Methods: As part of the Copenhagen City Heart Study, 8045 men and women aged 30–60 years with normal lung function at baseline were followed for 25 years. Lung function measurements were collected and mortality from COPD during the 25 year observation period was analysed.

Results: The percentage of men with normal lung function ranged from 96% of never smokers to 59% of continuous smokers; for women the proportions were 91% and 69%, respectively. The 25 year incidence of moderate and severe COPD was 20.7% and 3.6%, respectively, with no apparent difference between men and women. Smoking cessation, especially early in the follow up period, decreased the risk of developing COPD substantially compared with continuous smoking. During the follow up period there were 2912 deaths, 109 of which were from COPD. 92% of the COPD deaths occurred in subjects who were current smokers at the beginning of the follow up period.

Conclusion: The absolute risk of developing COPD among continuous smokers is at least 25%, which is larger than was previously estimated.

Abbreviations: COPD, chronic obstructive pulmonary disease; FEV₁, forced expiratory volume in 1 second; FVC, forced vital capacity

Keywords: chronic obstructive pulmonary disease; ventilatory function; smoking; prognosis

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

Relevant Article

Airwaves

Wisia Wedzicha
Thorax 2006 61: 923. [Extract] [Full Text] [PDF]

This article has been cited by other articles:

• Young, R P, Hopkins, R J, Hay, B A, Epton, M J, Mills, G D, Black, P N, Gardner, H D, Sullivan, R, Gamble, G D (2009). A gene-based risk score for lung cancer susceptibility in smokers and ex-smokers. Postgrad. Med. J. 85: 515-524 [Abstract] [Full Text]  
• Shaykhiev, R., Krause, A., Salit, J., Strulovici-Barel, Y., Harvey, B.-G., O'Connor, T. P., Crystal, R. G. (2009). Smoking-Dependent Reprogramming of Alveolar Macrophage Polarization: Implication for Pathogenesis of Chronic Obstructive Pulmonary Disease. J. Immunol. 183: 2867-2883 [Abstract] [Full Text]  
• Young, R. P., Hopkins, R. J., Christmas, T., Black, P. N., Metcalf, P., Gamble, G. D. (2009). COPD prevalence is increased in lung cancer, independent of age, sex and smoking history. Eur Respir J 34: 380-386 [Abstract] [Full Text]  
• Gibson, P G, Simpson, J L (2009). The overlap syndrome of asthma and COPD: what are its features and how important is it?. Thorax 64: 728-735 [Abstract] [Full Text]  
• Young, R P, Hopkins, R, Eaton, T E (2009). Potential benefits of statins on morbidity and mortality in chronic obstructive pulmonary disease: a review of the evidence. Postgrad. Med. J. 85: 414-421 [Abstract] [Full Text]  
• Nettleton, J. A., Follis, J. L., Schabath, M. B. (2009). Coffee Intake, Smoking, and Pulmonary Function in the Atherosclerosis Risk in Communities Study. Am J Epidemiol 169: 1445-1453 [Abstract] [Full Text]  
• Kohansal, R., Soriano, J. B., Agusti, A. (2009). Investigating the Natural History of Lung Function: Facts, Pitfalls, and Opportunities. Chest 135: 1330-1341 [Abstract] [Full Text]  
• Himes, B. E., Dai, Y., Kohane, I. S., Weiss, S. T., Ramoni, M. F. (2009). Prediction of Chronic Obstructive Pulmonary Disease (COPD) in Asthma Patients Using Electronic Medical Records. J. Am. Med. Inform. Assoc. 16: 371-379 [Abstract] [Full Text]  
• van Durme, Y. M.T.A., Verhamme, K. M.C., Aarnoudse, A.-J. L.H.J., Van Pottelberge, G. R., Hofman, A., Witteman, J. C.M., Joos, G. F., Brusselle, G. G., Stricker, B. H.C. (2009). C-Reactive Protein Levels, Haplotypes, and the Risk of Incident Chronic Obstructive Pulmonary Disease. Am. J. Respir. Crit. Care Med. 179: 375-382 [Abstract] [Full Text]  
• Rennard, S. I., Vestbo, J. (2008). Natural Histories of Chronic Obstructive Pulmonary Disease. Proc Am Thorac Soc 5: 878-883 [Abstract] [Full Text]  
• Kirkham, S., Kolsum, U., Rousseau, K., Singh, D., Vestbo, J., Thornton, D. J. (2008). MUC5B Is the Major Mucin in the Gel Phase of Sputum in Chronic Obstructive Pulmonary Disease. Am. J. Respir. Crit. Care Med. 178: 1033-1039 [Abstract] [Full Text]  
• Young, R. P., Hopkins, R. J., Hay, B. A., Epton, M. J., Black, P. N., Gamble, G. D. (2008). Lung cancer gene associated with COPD: triple whammy or possible confounding effect?. Eur Respir J 32: 1158-1164 [Abstract] [Full Text]  
• Godtfredsen, N. S., Lam, T. H., Hansel, T. T., Leon, M. E., Gray, N., Dresler, C., Burns, D. M., Prescott, E., Vestbo, J. (2008). COPD-related morbidity and mortality after smoking cessation: status of the evidence. Eur Respir J 32: 844-853 [Abstract] [Full Text]  
• Vestbo, J. (2008). COPD, diagrams and traditions: time to move on?. Thorax 63: 755-756 [Full Text]  
• Kim, K. M., Park, S. H., Kim, J. S., Lee, W. K., Cha, S. I., Kim, C. H., Kang, Y. M., Jung, T. H., Kim, I. S., Park, J. Y. (2008). Polymorphisms in the type IV collagen {alpha}3 gene and the risk of COPD. Eur Respir J 32: 35-41 [Abstract] [Full Text]  
• Bratke, K., Klug, M., Bier, A., Julius, P., Kuepper, M., Virchow, J. C., Lommatzsch, M. (2008). Function-Associated Surface Molecules on Airway Dendritic Cells in Cigarette Smokers. Am. J. Respir. Cell Mol. Bio. 38: 655-660 [Abstract] [Full Text]  
• Ammous, Z., Hackett, N. R., Butler, M. W., Raman, T., Dolgalev, I., O'Connor, T. P., Harvey, B.-G., Crystal, R. G. (2008). Variability in Small Airway Epithelial Gene Expression Among Normal Smokers. Chest 133: 1344-1353 [Abstract] [Full Text]  
• Gingo, M. R., Silveira, L. J., Miller, Y. E., Friedlander, A. L., Cosgrove, G. P., Chan, E. D., Maier, L. A., Bowler, R. P. (2008). Tumour necrosis factor gene polymorphisms are associated with COPD. Eur Respir J 31: 1005-1012 [Abstract] [Full Text]  
• Reilly, K. H., Gu, D., Duan, X., Wu, X., Chen, C.-S., Huang, J., Kelly, T. N., Chen, J., Liu, X., Yu, L., Bazzano, L. A., He, J. (2008). Risk Factors for Chronic Obstructive Pulmonary Disease Mortality in Chinese Adults. Am J Epidemiol 167: 998-1004 [Abstract] [Full Text]  
• Viegi, G., Pistelli, F., Sherrill, D. L., Maio, S., Baldacci, S., Carrozzi, L. (2007). Definition, epidemiology and natural history of COPD. Eur Respir J 30: 993-1013 [Abstract] [Full Text]  
• Sadeghnejad, A., Meyers, D. A., Bottai, M., Sterling, D. A., Bleecker, E. R., Ohar, J. A. (2007). IL13 Promoter Polymorphism 1112C/T Modulates the Adverse Effect of Tobacco Smoking on Lung Function. Am. J. Respir. Crit. Care Med. 176: 748-752 [Abstract] [Full Text]  
• Young, R. P., Hopkins, R., Eaton, T. E. (2007). Forced expiratory volume in one second: not just a lung function test but a marker of premature death from all causes. Eur Respir J 30: 616-622 [Abstract] [Full Text]  
• Mak, J. C. W., Ho, S. P., Yu, W. C., Choo, K. L., Chu, C. M., Yew, W. W., Lam, W. K., Chan-Yeung, M., on behalf of the Hong Kong Thoracic Society Chroni, (2007). Polymorphisms and functional activity in superoxide dismutase and catalase genes in smokers with COPD. Eur Respir J 30: 684-690 [Abstract] [Full Text]  
• Hughes, G. (2007). Hygieia. J. Epidemiol. Community Health 61: 272-272 [Full Text]  
• Vestbo, J. (2007). Chronic Cough and Phlegm in Young Adults: Should We Worry?. Am. J. Respir. Crit. Care Med. 175: 2-3 [Full Text]  
• Anthonisen, N R (2006). "Susceptible" smokers?. Thorax 61: 924-925 [Full Text]