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COPD's changing face

NEW YORK--At a time when death rates from other diseases are coming down, death rates from chronic obstructive pulmonary disease (COPD) are rising, with women accounting for the increase in this devastating disease, according to A. Sonia Buist, M.D., an international expert on the prevalence and management of COPD.

"In the 30 years from 1968 to 1998, when mortality from all cardiovascular disease was falling, when mortality from coronary-artery disease went down 60 percent, COPD mortality rose 163 percent," said Dr. Buist, professor of medicine at the Oregon Health & Science University.

"The startling fact is that during this period, the death rate in men has pretty much leveled off--it may even have gone down a little," said Dr. Buist. "The very rapid increase in the deaths of women from COPD is what accounts for the huge increase."

COPD has long been thought of as a man's disease, according to Dr. Buist. This is because the major risk factors for COPD in the developed world are smoking and occupational exposures to pollutants, especially particulates. For a long time these risk factors really applied only to men.

"Starting in the 1960s we see women began to catch up to men," said Dr. Buist. "Women started smoking in large numbers in the 1930s and '40s. At the same time, women also began to move into the workplace, exposing them to occupational hazards, as well. COPD prevalence in men and women in the U.S. is now probably about equal, reflecting the equality in the smoking habits of men and women and the improved opportunities in the workforce for women."

There is a need for education about COPD, according to Dr. Buist. COPD is under diagnosed, with few doctors understanding the need to do lung function testing with patients exhibiting early symptoms. "We are not catching people in the early stages of the disease," said Dr. Buist. "We are not picking it up until the disease is very advanced and there is little that we can d
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Contact: Tamara Hargens
hargens@ohsu.edu
503-494-8231
American Medical Association
6-Nov-2003


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