The age-adjusted prevalence of chronic obstructive pulmonary disease (COPD) varies considerably within the United States, from less than 4 percent of the population in Washington and Minnesota to more than 9 percent in Alabama and Kentucky. These state-level rates are among the COPD data available for the first time as part of the newly released 2011 Behavioral Risk Factor Surveillance System (BRFSS) survey.
"COPD is a tremendous public health burden and a leading cause of death. It is a health condition that needs to be urgently addressed, particularly on a local level," said Nicole Kosacz, M.P.H., an epidemiologist with the Centers for Disease Control and Prevention and one of the lead analysts of the data. "This first-ever state-level analysis and breakdown is a critical source of information that will allow states to focus their resources where they will have maximum impact."
In addition to the nationwide prevalence data, surveys in 21 states as well as Washington, D.C., and Puerto Rico asked additional questions related to diagnosis and quality of life of those reporting COPD. Results from the more detailed surveys included:
71.4 percent of those reporting COPD were diagnosed via spirometry -- a simple test to assess breathing
62.5 percent felt that symptoms adversely affected their quality of life
50.9 percent were taking at least one daily medication to manage their COPD, with rates of medication usage increasing with age
"These findings illustrate that we still need improvement in raising awareness about COPD and its diagnosis and management," said James Kiley, Ph.D., director of the Division of Lung Diseases at the National Heart, Lung, and Blood Institute (NHLBI), part of the National Institutes of Health. "COPD can be well-controlled, but it's critical to diagnose it early and to follow the appropriate therapeutic strategies."
The BRFSS surveys adults aged 18 or older and is administered by state health departments in collaboration with the CDC. The addition of state-level COPD surveillance data in the 2011 study was co-supported by the NHLBI and the CDC. Nearly 500,000 people responded to the survey; 39,000 reported having COPD. The COPD data from the BRFSS survey will appear in the Nov. 23 edition of the CDC's Morbidity and Mortality Weekly Report.
COPD, which includes conditions such as emphysema and chronic bronchitis, is characterized by shortness of breath, chronic coughing or wheezing, or excess sputum (airway mucus) production. COPD develops slowly and worsens over time, causing many people to ignore the symptoms early on and delay seeking diagnosis and treatment until the disease is in its late stages.
The BRFSS survey found that nationwide, 6 percent of non-institutionalized adults, or approximately 15 million people, reported having COPD, with the highest prevalence clustered around the Ohio and lower Mississippi rivers. However, since the study did not survey older adults in institutions like nursing homes, the actual number is likely higher.
Other nationwide results for COPD included:
Women were more likely to report COPD than men (6.7 percent vs. 5.2 percent)
Prevalence was lower among homemakers, students, and the employed than among those who were unable to work, unemployed, or retired
Prevalence decreased as income increased (from 9.9 percent among those making less than $25,000 a year to 2.8 percent among those making more than $75,000)
36.4 percent of those reporting COPD were former smokers
38.7 percent of those reporting COPD continued to smoke
43.7 percent of those reporting COPD had a history of asthma
The BRFSS is conducted using random telephone calls (landline and cellular). The survey assesses risk behaviors and other factors that contribute to the leading causes of death in the United States.
Wednesday, 28 November 2012
Friday, 23 November 2012
Roflumilast Betters Lung Function After 6 Months Compared With Placebo
Roflumilast was associated with significant improvements in lung function in patients with moderate and severe chronic obstructive pulmonary disease (COPD) after 6 months of treatment compared with placebo. Roflumilast is approved to reduce the risk of exacerbations in patients with severe COPD associated with chronic bronchitis and a history of exacerbations.
To examine the drug's impact on lung function, researchers from multiple institutions, including Baylor College of Medicine; Takeda Pharmaceuticals International GmbH; and Forest Research Institute, randomized 4,746 subjects to roflumilast (pooled intent-to-treat [ITT], n= 2511; moderate COPD, n=1184; severe COPD, n=1217) or placebo (pooled ITT, n=2235; moderate COPD, n=1098; severe COPD, n=1062). Baseline demographics were similar between treatment groups.
At 6 months, roflumilast increased pre- and postbronchodilator FEV1 by 66 mL and 67 mL, respectively, compared with placebo. Roflumilast, compared with placebo, also increased pre- and postbronchodilator FEV1 in subjects with moderate and severe COPD.
This study was presented during CHEST 2012, the annual meeting of the American College of Chest Physicians, held October 20 -- 25, in Atlanta, Georgia.
To examine the drug's impact on lung function, researchers from multiple institutions, including Baylor College of Medicine; Takeda Pharmaceuticals International GmbH; and Forest Research Institute, randomized 4,746 subjects to roflumilast (pooled intent-to-treat [ITT], n= 2511; moderate COPD, n=1184; severe COPD, n=1217) or placebo (pooled ITT, n=2235; moderate COPD, n=1098; severe COPD, n=1062). Baseline demographics were similar between treatment groups.
At 6 months, roflumilast increased pre- and postbronchodilator FEV1 by 66 mL and 67 mL, respectively, compared with placebo. Roflumilast, compared with placebo, also increased pre- and postbronchodilator FEV1 in subjects with moderate and severe COPD.
This study was presented during CHEST 2012, the annual meeting of the American College of Chest Physicians, held October 20 -- 25, in Atlanta, Georgia.
Tuesday, 20 November 2012
Drinking Large Quantities of Soft Drinks Linked With COPD and Asthma
A new study published in the journal Respirology reveals that a high level of soft drink consumption is associated with asthma and/or chronic obstructive pulmonary disease (COPD).
Led by Zumin Shi, MD, PhD, of the University of Adelaide, researchers conducted computer assisted telephone interviewing among 16,907 participants aged 16 years and older in South Australia between March 2008 and June 2010 inquiring about soft drink consumption. Soft drinks comprised Coke, lemonade, flavored mineral water, Powerade, and Gatorade etc.
Results showed that one in ten adults drink more than half a liter of soft drink daily in South Australia. The amount of soft drink consumption is associated with an increased chance of asthma and/or COPD. There exists a dose-response relationship, which means the more soft drink one consumes, the higher the chance of having these diseases.
Overall, 13.3% of participants with asthma and 15.6% of those with COPD reported consuming more than half a liter of soft drink per day.
The odds ratio for asthma and COPD was 1.26 and 1.79, comparing those who consumed more than half a liter of soft drink per day with those who did not consume soft drinks.
Furthermore, smoking makes this relationship even worse, especially for COPD. Compared with those who did not smoke and consume soft drinks, those that consumed more than half a liter of soft drink per day and were current smokers had a 6.6-fold greater risk of COPD.
"Our study emphasizes the importance of healthy eating and drinking in the prevention of chronic diseases like asthma and COPD," Zumin concludes.
Led by Zumin Shi, MD, PhD, of the University of Adelaide, researchers conducted computer assisted telephone interviewing among 16,907 participants aged 16 years and older in South Australia between March 2008 and June 2010 inquiring about soft drink consumption. Soft drinks comprised Coke, lemonade, flavored mineral water, Powerade, and Gatorade etc.
Results showed that one in ten adults drink more than half a liter of soft drink daily in South Australia. The amount of soft drink consumption is associated with an increased chance of asthma and/or COPD. There exists a dose-response relationship, which means the more soft drink one consumes, the higher the chance of having these diseases.
Overall, 13.3% of participants with asthma and 15.6% of those with COPD reported consuming more than half a liter of soft drink per day.
The odds ratio for asthma and COPD was 1.26 and 1.79, comparing those who consumed more than half a liter of soft drink per day with those who did not consume soft drinks.
Furthermore, smoking makes this relationship even worse, especially for COPD. Compared with those who did not smoke and consume soft drinks, those that consumed more than half a liter of soft drink per day and were current smokers had a 6.6-fold greater risk of COPD.
"Our study emphasizes the importance of healthy eating and drinking in the prevention of chronic diseases like asthma and COPD," Zumin concludes.
Sunday, 18 November 2012
World COPD Day Sees Launch Of biggest Respiratory Genetics Study
Researchers from the Universities of Nottingham and Leicester are leading the largest ever study of the genetics relating to lung disease.
The project will investigate what determines an individual's lung health and why smoking harms the lungs of some people more than others and will use health information held by UK Biobank, a major national resource holding health information from half a million volunteers.
The study, funded by the Medical Research Council (MRC) and also involving scientists at St George's, University of London, is aiming to shed light on why some people are genetically more prone to suffer from lung disease, particularly chronic obstructive pulmonary disease (COPD).
COPD includes conditions such as chronic bronchitis and emphysema and is the sixth most common cause of death in the UK (around 30,000 deaths per year). It affects approximately 900,000 people in the UK and costs the NHS £150m every year. At present, avoiding taking up smoking or, for those who already smoke, stopping smoking remain the most effective ways to prevent COPD. Genetic factors
The World Health Organisation (WHO) estimates that COPD is the 4th leading cause of death worldwide but it is predicted to move into 3rd place in the near future. The new project was launched on World COPD Day.
The research aims to discover the genes which affect lung function and also those which may affect the chances of developing lung disease for both smokers and non-smokers. It will also investigate whether genes play a part in the ability, or failure, to maintain good lung health for smokers and non-smokers. The researchers will also be able to investigate genetic factors that may affect the likelihood of an individual becoming addicted to smoking.
The study, which is called UK BiLEVE (UK Biobank Lung Exome Variant Evaluation), will be one of the first projects to make use of UK Biobank, the world's largest resource of its kind.
All UK Biobank participants have already had their lung function measured and given information about their smoking habits, past and present. In this study, researchers will use anonymous data from 50,000 of these participants to determine genetic variants associated with susceptibility to COPD. They will look at both rare and common single nucleotide polymorphisms (tiny variations in genes) in the participants' DNA and the lung function of those who are heavy smokers and those who have never smoked.
Unique resource
Leading the research is Professor Ian Hall, Dean of The University of Nottingham's Medical School. He said: "We currently know very little about why there is such a wide difference in lung health, even among smokers. We believe genetic factors play an important role so we're extremely excited about using the unique resource of Biobank to test this theory in detail. This study couldn't be done anywhere else in the world."
Professor David Lomas, Chair of the MRC Population and Systems Medicine Board, said: "We know that smoking is unhealthy for anyone but we know little about why the lungs of most smokers are seriously affected, while those of some seem to stay relatively healthy. If we knew more about the genetics that cause this variation we would be better able to direct treatments to those who are most at risk and have an increased chance of developing drugs to target this type of lung disease."
Professor Sir Rory Collins, UK Biobank Principal Investigator, said: "We are extremely grateful to the half a million people throughout Britain who went out of their way to join UK Biobank. Their commitment will provide key insights into a wide range of illnesses that kill and cause pain and suffering. Last week we heard of plans to use the resource to study dementia. This week UK Biobank helps scientists tackle a serious lung condition. UK Biobank will become a key resource to improve health in the 21st century. We are grateful to the MRC, Wellcome Trust and Department of Health for having the vision to back such an initiative."
The project will investigate what determines an individual's lung health and why smoking harms the lungs of some people more than others and will use health information held by UK Biobank, a major national resource holding health information from half a million volunteers.
The study, funded by the Medical Research Council (MRC) and also involving scientists at St George's, University of London, is aiming to shed light on why some people are genetically more prone to suffer from lung disease, particularly chronic obstructive pulmonary disease (COPD).
COPD includes conditions such as chronic bronchitis and emphysema and is the sixth most common cause of death in the UK (around 30,000 deaths per year). It affects approximately 900,000 people in the UK and costs the NHS £150m every year. At present, avoiding taking up smoking or, for those who already smoke, stopping smoking remain the most effective ways to prevent COPD. Genetic factors
The World Health Organisation (WHO) estimates that COPD is the 4th leading cause of death worldwide but it is predicted to move into 3rd place in the near future. The new project was launched on World COPD Day.
The research aims to discover the genes which affect lung function and also those which may affect the chances of developing lung disease for both smokers and non-smokers. It will also investigate whether genes play a part in the ability, or failure, to maintain good lung health for smokers and non-smokers. The researchers will also be able to investigate genetic factors that may affect the likelihood of an individual becoming addicted to smoking.
The study, which is called UK BiLEVE (UK Biobank Lung Exome Variant Evaluation), will be one of the first projects to make use of UK Biobank, the world's largest resource of its kind.
All UK Biobank participants have already had their lung function measured and given information about their smoking habits, past and present. In this study, researchers will use anonymous data from 50,000 of these participants to determine genetic variants associated with susceptibility to COPD. They will look at both rare and common single nucleotide polymorphisms (tiny variations in genes) in the participants' DNA and the lung function of those who are heavy smokers and those who have never smoked.
Unique resource
Leading the research is Professor Ian Hall, Dean of The University of Nottingham's Medical School. He said: "We currently know very little about why there is such a wide difference in lung health, even among smokers. We believe genetic factors play an important role so we're extremely excited about using the unique resource of Biobank to test this theory in detail. This study couldn't be done anywhere else in the world."
Professor David Lomas, Chair of the MRC Population and Systems Medicine Board, said: "We know that smoking is unhealthy for anyone but we know little about why the lungs of most smokers are seriously affected, while those of some seem to stay relatively healthy. If we knew more about the genetics that cause this variation we would be better able to direct treatments to those who are most at risk and have an increased chance of developing drugs to target this type of lung disease."
Professor Sir Rory Collins, UK Biobank Principal Investigator, said: "We are extremely grateful to the half a million people throughout Britain who went out of their way to join UK Biobank. Their commitment will provide key insights into a wide range of illnesses that kill and cause pain and suffering. Last week we heard of plans to use the resource to study dementia. This week UK Biobank helps scientists tackle a serious lung condition. UK Biobank will become a key resource to improve health in the 21st century. We are grateful to the MRC, Wellcome Trust and Department of Health for having the vision to back such an initiative."
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