US COPD fall ‘cause for cautious optimism’
By Kirsty Oswald, medwireNews Reporter
03 May 2013
Chest 2013; Advance online publication

medwireNews: US data show that during the previous decade, the age-adjusted prevalence of chronic obstructive pulmonary disease (COPD) significantly declined.

Between 1999 and 2010, the COPD-related mortality rate among men and rates of hospitalizations also decreased, leading the study authors to suggest that COPD prevention strategies may be proving effective.

However, they caution that the disease remains one of the country's largest causes of morbidity and mortality.

"The data… testify to the heavy public health burden that COPD continues to levy in the United States," say study author Earl Ford (Centers for Disease Control and Prevention, Atlanta, Georgia) and colleagues.

Data collated from the annual National Health Interview Survey showed that between 1999 and 2011, the prevalence of COPD fluctuated between years, but overall there was a significant linear decline in age-adjusted prevalence among adults aged 18 years and over. Meanwhile, the results of a national telephone survey indicated that 13.7 million adults over the age of 25 years, representing 6.5% of US adults, had a self-reported COPD diagnosis in 2011.

Death certificate records showed that the annual number of deaths from COPD increased over the 1999 to 2010 period from 118,456 to 133,575. However, after adjusting for age, the annual death rate among men fell significantly from 88.2 to 73.6 per 100,000, although there was no change among women or overall.

The authors found no significant change in office visit rates or emergency department visits between 1999 and 2010. However, age-adjusted hospitalization rates fell over the same time period among adults aged over 25 years (40.2 vs 32.2/10,000), men (39.9 vs 31.6/10,000), and women (40.8 vs 33.4/10,000), and age-specific rates fell in all age groups except 45 to 54-year olds.

Ford and colleagues say that as smoking prevalence continues to decline, and COPD management improves, the COPD mortality rate should decrease in future. This could be enhanced by greater physician adherence to the Global Initiative for Chronic Obstructive Lung Disease guidelines, as well as improved public awareness efforts targeted at areas with the highest COPD burden, they add.

"Prior to 1999, rates of mortality and hospitalizations had shown worrisome increases," the authors write in Chest.

"Thus, the apparent leveling of the mortality rate and a decrease in the rate of hospitalization represent cause for cautious optimism," they conclude.

medwireNews (www.medwirenews.com) is an independent clinical news service provided by Springer Healthcare Limited. © Springer Healthcare Ltd; 2013

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