Chronic obstructive pulmonary disease mortality and prevalence: the associations with smoking and poverty—a BOLD analysis. Issue 5 (18th December 2013)

• Record Type: Journal Article
• Authors: Burney, Peter; Jithoo, Anamika; Kato, Bernet; Janson, Christer; Mannino, David; Niżankowska-Mogilnicka, Ewa; Studnicka, Michael; Tan, Wan; Bateman, Eric; Koçabas, Ali; Vollmer, William M; Gislason, Thorarrin; Marks, Guy; Koul, Parvaiz A; Harrabi, Imed; Gnatiuc, Louisa; Buist, Sonia
• Other Names: Zhong NanShan author non-byline.; Liu Shengming author non-byline.; Lu Jiachun author non-byline.; Ran Pixin author non-byline.; Wang Dali author non-byline.; Zheng Jingping author non-byline.; Zhou Yumin author non-byline.; Kocabaş Ali author non-byline.; Hancioglu Attila author non-byline.; Hanta Ismail author non-byline.; Kuleci Sedat author non-byline.; Turkyilmaz Ahmet Sinan author non-byline.; Umut Sema author non-byline.; Unalan Turgay author non-byline.; Studnicka Michael author non-byline.; Dawes Torkil author non-byline.; Lamprecht Bernd author non-byline.; Schirhofer Lea author non-byline.; Bateman Eric author non-byline.; Jithoo Anamika author non-byline.; Adams Desiree author non-byline.; Barnes Edward author non-byline.; Freeman Jasper author non-byline.; Hayes Anton author non-byline.; Hlengwa Sipho author non-byline.; Johannisen Christine author non-byline.; Koopman Mariana author non-byline.; Louw Innocentia author non-byline.; Ludick Ina author non-byline.; Olckers Alta author non-byline.; Ryck Johanna author non-byline.; Storbeck Janita author non-byline.; Gislason Thorarinn author non-byline.; Benedikdtsdottir Bryndis author non-byline.; Jörundsdottir Kristin author non-byline.; Gudmundsdottir Lovisa author non-byline.; Gudmundsdottir Sigrun author non-byline.; Gundmundsson Gunnar author non-byline.; Nizankowska-Mogilnicka Ewa author non-byline.; Frey Jakub author non-byline.; Harat Rafal author non-byline.; Mejza Filip author non-byline.; Nastalek Pawel author non-byline.; Pajak Andrzej author non-byline.; Skucha Wojciech author non-byline.; Szczeklik Andrzej author non-byline.; Twardowska Magda author non-byline.; Welte Tobias author non-byline.; Bodemann Isabelle author non-byline.; Geldmacher Henning author non-byline.; Schweda-Linow Alexandra author non-byline.; Gulsvik Amund author non-byline.; Endresen Tina author non-byline.; Svendsen Lene author non-byline.; Tan Wan C author non-byline.; Wang Wen author non-byline.; Mannino David M author non-byline.; Cain John author non-byline.; Copeland Rebecca author non-byline.; Hazen Dana author non-byline.; Methvin Jennifer author non-byline.; Dantes Renato B author non-byline.; Amarillo Lourdes author non-byline.; Berratio Lakan U author non-byline.; Fernandez Lenora C author non-byline.; Francisco Norberto A author non-byline.; Garcia Gerard S author non-byline.; de Guia Teresita S author non-byline.; Idolor Luisito F author non-byline.; Naval Sullian S author non-byline.; Reyes Thessa author non-byline.; Roa Camilo C author non-byline.; Sanchez Ma Flordeliza author non-byline.; Simpao Leander P author non-byline.; Jenkins Christine author non-byline.; Marks Guy author non-byline.; Bird Tessa author non-byline.; Espinel Paola author non-byline.; Hardaker Kate author non-byline.; Toelle Brett author non-byline.; Burney Peter G J author non-byline.; Amor Caron author non-byline.; Potts James author non-byline.; Tumilty Michael author non-byline.; McLean Fiona author non-byline.; Wouters E F M author non-byline.; Wesseling G J author non-byline.; Bárbara Cristina author non-byline.; Rodrigues Fátima author non-byline.; Dias Hermínia author non-byline.; Cardoso João author non-byline.; Almeida João author non-byline.; Matos Maria João author non-byline.; Simão Paula author non-byline.; Santos Moutinho author non-byline.; Ferreira Reis author non-byline.; Janson Christer author non-byline.; Olafsdottir Inga Sif author non-byline.; Nisser Katarina author non-byline.; Spetz-Nyström Ulrike author non-byline.; Hägg Gunilla author non-byline.; Lund Gun-Marie author non-byline.; Jõgi Rain author non-byline.; Laja Hendrik author non-byline.; Ulst Katrin author non-byline.; Zobel Vappu author non-byline.; Lill Toomas-Julius author non-byline.; Koul Parvaiz A author non-byline.; Malik Sajjad author non-byline.; Hakim Nissar A author non-byline.; Khan Umar Hafiz author non-byline.; Chowgule Rohini author non-byline.; Shetye Vasant author non-byline.; Raphael Jonelle author non-byline.; Almeda Rosel author non-byline.; Tawde Mahesh author non-byline.; Tadvi Rafiq author non-byline.; Katkar Sunil author non-byline.; Kadam Milind author non-byline.; Dhanawade Rupesh author non-byline.; Ghurup Umesh author non-byline.; Harrabi Imed author non-byline.; Denguezli Myriam author non-byline.; Tabka Zouhair author non-byline.; Daldoul Hager author non-byline.; Boukheroufa Zaki author non-byline.; Chouikha Firas author non-byline.; Khalifa Wahbi Belhaj author non-byline.; Idolor Luisito F author non-byline.; de Guia Teresita S author non-byline.; Francisco Norberto A author non-byline.; Roa Camilo C author non-byline.; Ayuyao Fernando G author non-byline.; Tady Cecil Z author non-byline.; Tan Daniel T author non-byline.; Banal-Yang Sylvia author non-byline.; Balanag Vincent M author non-byline.; Reyes Maria Teresita N author non-byline.; Dantes Renato B author non-byline.; Salvi Sundeep author non-byline.; Hirve Siddhi author non-byline.; Brashier Bill author non-byline.; Londhe Jyoti author non-byline.; Madas Sapna author non-byline.; Sambhudas Somnath author non-byline.; Chaidhary Bharat author non-byline.; Tambe Meera author non-byline.; Pingale Savita author non-byline.; Umap Arati author non-byline.; Umap Archana author non-byline.; Shelar Nitin author non-byline.; Devchakke Sampada author non-byline.; Chaudhary Sharda author non-byline.; Bondre Suvarna author non-byline.; Walke Savita author non-byline.; Gawhane Ashleshsa author non-byline.; Sapkal Anil author non-byline.; Argade Rupali author non-byline.; Gaikwad Vijay author non-byline.; Crapo R O author non-byline.; Jensen R L author non-byline.; Enright Paul author non-byline.; Harnoncourt Georg author non-byline.;
• Is Part Of: Thorax. Volume 69:Issue 5(2014)
• Page Start: 465
• Page End: 473
• Publication Date: 2013-12-18
• Subjects: COPD epidemiology -- Tobacco and the lung -- Lung Physiology; Chest -- Diseases -- Periodicals; Thorax; Chest -- Diseases; Periodicals; Periodicals; 617.54
• DOI: 10.1136/thoraxjnl-2013-204460
• Languages: English
• ISSNs: 0040-6376

Abstract

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 rs =0.73, p=0.0001; women rs =0.90, p<0.0001; 60+ years: men rs =0.63, p=0.0022; women rs =0.37, p=0.1) than obstruction (<60 years: men rs =0.28, p=0.20; women rs =0.17, p<0.46; 60+ years: men rs =0.28, p=0.23; women rs =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.