Incidence trends of airflow obstruction among European adults without asthma: a 20-year cohort study

Abstract

Investigating COPD trends may help healthcare providers to forecast future disease burden. We estimated sex-and smoking-specific incidence trends of pre-bronchodilator airflow obstruction (AO) among adults without asthma from 11 European countries within a 20-year follow-up (ECRHS and SAPALDIA cohorts). We also quantified the extent of misclassification in the definition based on prebronchodilator spirometry (using post-bronchodilator measurements from a subsample of subjects) and we used this information to estimate the incidence of post-bronchodilator AO (AO post-BD), which is the primary characteristic of COPD. AO incidence was 4.4 (95% CI: 3.5-5.3) male and 3.8 (3.1-4.6) female cases/1,000/year. Among ever smokers (median pack-years: 20, males; 12, females), AO incidence significantly increased with ageing in men only [incidence rate ratio (IRR), 1-year increase: 1.05 (1.03-1.07)]. A strong exposure-response relationship with smoking was found both in males [IRR, 1-packyear increase: 1.03 (1.02-1.04)] and females [1.03 (1.02-1.05)]. The positive predictive value of AO for Ao post-BD was 59.1% (52.0-66.2%) in men and 42.6% (35.1-50.1%) in women. AO post-BD incidence was 2.6 (1.7-3.4) male and 1.6 (1.0-2.2) female cases/1,000/year. AO incidence was considerable in Europe and the sex-specific ageing-related increase among ever smokers was strongly related to cumulative tobacco exposure. Ao post-BD incidence is expected to be half of AO incidence. Chronic Obstructive Pulmonary Disease (COPD) is a major cause of chronic morbidity and mortality worldwide 1 , and it represents an important public health challenge, being both a preventable and treatable disease 2. Globally, the COPD burden is projected to increase in coming decades because of continued exposure to risk factors and ageing of the population 3. COPD is characterised by a progressive airflow obstruction that is not fully reversible 4. According to the Global Initiative for Chronic Obstructive Lung Disease guidelines 2 , the diagnosis of COPD requires post-bronchodilator

Characteristics of Lung Function and Prevalence of Airflow Obstruction Among Individuals Aged 18–74 Years — Beijing, China, 2017–2018

“…Importantly, AFO has been found to be a critical element of certain diseases, such as chronic obstructive pulmonary disease (COPD) (2). Among individuals with AFO, 43%-74% are COPD patients (3)(4)(5), and COPD has become a major public health problem in China (6). The aim of this study was thus to estimate the level and characteristics of lung function and AFO in a sample population of adults living in Beijing in order to better serve populations such as those suffering from COPD.…”

Bronchodilator response and lung function decline: Associations with exhaled nitric oxide with regard to sex and smoking status

“…Some centres had other equipment, but these differences are not believed to have affected the homogeneity of the results. 29 The type of spirometer used at each centre has been presented by Accordini et al 30 Spirometry measurements were performed with the study person in a sitting position, wearing a nose clip, and in accordance with the instructions of the American Thoracic Society (ATS)/European Respiratory Society (ERS). 31 All spirometry tests fulfilled the ATS data collection standards regarding validity of measurements, ie, 5 or more acceptable spirometry performances.…”

Mapping the global research landscape and hotspot of exercise therapy and chronic obstructive pulmonary disease: A bibliometric study based on the web of science database from 2011 to 2020

“…Exercise therapy (ET) is a therapeutic form of training that improves the body’s exercise endurance and improves cardiopulmonary function. Many studies have proved that aerobic exercise is an effective way to improve systemic inflammation ( Accordini et al, 2020 ), in particular, has a good effect on improving lung function and exercise ability, and reducing systemic inflammation in COPD patients ( Wen et al, 2019 ). Braz Júnior et al (2015) found that whole-body vibration (WBV) was effective in improving the 6-min walk distance (6MWD) ability of COPD patients with a good positive modulating effect on the quality of life assessed by the St. George’s Respiratory Questionnaire (SGRQ).…”