The American Lung Association reports that chronic obstructive pulmonary disease (COPD) is the sixth leading direct cause of death overall and the fifth leading disease-related cause of death in the United States.

In 2015, chronic lower respiratory diseases, including COPD, were the third most common cause of death, according to the Centers for Disease Control and Prevention (CDC). Despite the overall decrease, in late 2021, Mayo Clinic reported that an estimated 16 million Americans have a form of COPD. This disease has been linked to a number of life-threatening medical conditions.

What COPD is

COPD refers to several abnormal breathing conditions. These problems in the lungs cause problems for the heart and other organs throughout the body. Among the lung diseases that comprise the major types of COPD are progressive and chronic bronchitis, emphysema and non-reversible asthma, called refractory asthma.

Sufferers of chronic bronchitis are subject to long-term, mucus-producing coughing. Emphysema is a long-term destruction of the lungs in which the lung tissue is gradually damaged over an extended period.

AHA reports that people who develop late-onset asthma, or asthma that appears in adulthood, are 57% more likely to have cardiovascular issues than those without asthma. Asthma in adults can result in declining lung function that impedes proper breathing.

Complications caused by COPD

Among the causes of death to which COPD contributes are lung cancer, heart disease and coronary artery disease. Vascular Health Clinics lists COPD among the leading causes of chronic lung infections. Chronic lung infections exacerbated by COPD include pneumonia and bronchiectasis-related pneumonia, which is the inability to clear secretions. Bronchiectasis occurs by the widening of the airways in the lungs, creating difficulty for mucus to properly be expelled. The mucus becomes a breeding ground for bacteria, resulting in lung damage and inflammation.

Other complications may include the necessity for oxygen devices, such as tanks; difficulty walking or using stairs; depression and other mental issues. Social activities may also become difficult, and visits to physicians and hospital emergency departments can become more frequent.

Impact on various groups

Statistics from 2020 show that the COPD death rate decreased among men by 32% in the preceding 20 years. The COPD death rate among women remained about the same during that period. However, since 2020, the COPD death rate for women has risen in the United States. The CDC says one reason the rate is rising for females is that women are usually diagnosed later in life when the disease is more advanced. Women may also be more susceptible to certain causes of COPD, such as tobacco smoke and indoor air pollution.

While COPD deaths among those over age 65 have decreased in the past 20 years, that age group still accounts for 86% of COPD deaths.

Beyond age, COPD risk is 70% higher among smokers and 50% higher among former smokers than among the overall population. The CDC states that in 2020, research showed that 14.1% of adult men and 11% of adult women are current smokers. Overall, 12.5% of all U.S. adults (those over age 18), or over 30 million Americans, are smokers. Smoking-related diseases, including COPD, affect more than 16 million U.S. citizens, and cigarette smoking is considered the leading preventable cause of death.

In addition to cigarette smoking, genetics may play a role in a person’s risk for COPD. Exposure to dust and chemicals in work settings, as well as burning fumes and fuel, can also increase risk. While asthma and cigarette smoking are both risk factors, the combination of the two further intensifies COPD risk.

Treatment, management and prevention

After COPD is diagnosed, its severity may influence treatment options. For very mild cases, smoking cessation may be all that is necessary. For advanced cases, therapy options are numerous. They can include medications that may be prescribed as ongoing or as needed, and devices, including inhalers. Inhalers may dispense medications such as Albuterol, ipratropium or levalbuterol, all considered short-acting bronchodilators. Long-acting bronchodilators may be prescribed, as well as inhaled steroids, such as fluticasone. Other medications may include oral steroids and antibiotics.

For severe cases of COPD, lung therapies including oxygen therapies and pulmonary rehabilitation may be required. Severe emphysema may require surgery.

Measures that can be taken to reduce COPD risk include never starting smoking and eliminating smoking if one is a smoker. Avoiding second-hand smoke and maintaining regular flu vaccines also help.

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Omar P. Haqqani is the Chief of Vascular and Endovascular Surgery at Vascular Health Clinics in Midland.



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