Chronic obstructive pulmonary disease mortality and prevalence: the associations with smoking and poverty-a BOLD analysis

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Chronic obstructive pulmonary disease mortality and prevalence : the associations with smoking and poverty-a BOLD analysis

Burney, Peter (author)

Jithoo, Anamika (author)

Kato, Bernet (author)

Janson, Christer (author): Uppsala universitet,Lungmedicin och allergologi

Mannino, David (author)

Nizankowska-Mogilnicka, Ewa (author)

Studnicka, Michael (author)

Tan, Wan (author)

Bateman, Eric (author)

Kocabas, Ali (author)

Vollmer, William M. (author)

Gislason, Thorarrin (author)

Marks, Guy (author)

Koul, Parvaiz A. (author)

Harrabi, Imed (author)

Gnatiuc, Louisa (author)

Buist, Sonia (author)

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(creator_code:org_t)

2013-12-18
2014
English.
In: Thorax. - : BMJ. - 0040-6376 .- 1468-3296. ; 69:5, s. 465-473

Related links:: https://uu.diva-port... (primary) (Raw object); show more...; https://thorax.bmj.c...; https://urn.kb.se/re...; https://doi.org/10.1...; show less...

Journal article (peer-reviewed)

Abstract Subject headings

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

Subject headings

MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Lungmedicin och allergi (hsv//swe)
MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Respiratory Medicine and Allergy (hsv//eng)

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By the author/editor: Burney, Peter; Jithoo, Anamika; Kato, Bernet; Janson, Christer; Mannino, David; Nizankowska-Mogi ...; show more...; Studnicka, Micha ...; Tan, Wan; Bateman, Eric; Kocabas, Ali; Vollmer, William ...; Gislason, Thorar ...; Marks, Guy; Koul, Parvaiz A.; Harrabi, Imed; Gnatiuc, Louisa; Buist, Sonia; show less...

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MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Clinical Medicin ...; and Respiratory Medi ...

Articles in the publication: Thorax

By the university: Uppsala University

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