Nine out of 10 people with GOLD stage 1 chronic obstructive pulmonary disease (COPD) do not have lung disease and are not at substantially increased risk of developing lung disease during the next decade. The SAPALDIA investigators recently described the outcomes after 11 years of follow-up of 519 adults with GOLD stage 1 COPD, comparing them with 6061 with normal spirometry.1 More than one-third of these adults, both at the baseline and follow-up examinations, would have had normal …