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

Peter G. J. Burney; Anamika Jithoo; Bernet Kato; Christer Janson; David M. Mannino; Ewa Nizankowska-Mogilnicka; Michael Studnicka; Wan C. Tan; Eric Bateman; Ali Koçabas; William M. Vollmer; Thorarrin Gislason; Guy Marks; Parvaiz A. Koul; Imed Harrabi; Louisa Gnatiuc; Sonia Buist; the Burden of Obstructive Lung Disease (BOLD) Study

doi:10.1136/thoraxjnl-2013-204460

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

Peter G. J. Burney, Anamika Jithoo, Bernet Kato, Christer Janson, David M. Mannino, Ewa Nizankowska-Mogilnicka, Michael Studnicka, Wan C. Tan, Eric Bateman, Ali Koçabas, William M. Vollmer, Thorarrin Gislason, Guy Marks, Parvaiz A. Koul, Imed Harrabi, Louisa Gnatiuc, Sonia Buist, the Burden of Obstructive Lung Disease (BOLD) Study

Research output: Contribution to journal › Article › peer-review

196 Citations (Scopus)

14 Downloads (Pure)

Abstract

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

Original language	English
Pages (from-to)	465-473
Number of pages	9
Journal	Thorax
Volume	69
Issue number	5
DOIs	https://doi.org/10.1136/thoraxjnl-2013-204460
Publication status	Published - 1 May 2014
Externally published	Yes

Bibliographical note

Version archived for private and non-commercial use with the permission of the author/s and according to publisher conditions. For further rights please contact the publisher.

Access to Document

10.1136/thoraxjnl-2013-204460Licence: CC BY

Publisher version (open access)Final published version, 1.03 MBLicence: CC BY

Cite this

Burney, P. G. J., Jithoo, A., Kato, B., Janson, C., Mannino, D. M., Nizankowska-Mogilnicka, E., Studnicka, M., Tan, W. C., Bateman, E., Koçabas, A., Vollmer, W. M., Gislason, T., Marks, G., Koul, P. A., Harrabi, I., Gnatiuc, L., Buist, S., & the Burden of Obstructive Lung Disease (BOLD) Study (2014). Chronic obstructive pulmonary disease mortality and prevalence: the associations with smoking and poverty - a BOLD analysis. Thorax, 69(5), 465-473. https://doi.org/10.1136/thoraxjnl-2013-204460

@article{9f58d06aca6b414ba99957fbae56fbc2,

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

abstract = "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 rs=0.73, p=0.0001; women rs=0.90, p<0.0001; 60+ years: men rs=0.63, p=0.0022; women rs=0.37, p=0.1) than obstruction (<60 years: men rs=0.28, p=0.20; women rs=0.17, p<0.46; 60+ years: men rs=0.28, p=0.23; women rs=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 {\textquoteleft}COPD{\textquoteright} mortality in poor countries.",

author = "Burney, {Peter G. J.} and Anamika Jithoo and Bernet Kato and Christer Janson and Mannino, {David M.} and Ewa Nizankowska-Mogilnicka and Michael Studnicka and Tan, {Wan C.} and Eric Bateman and Ali Ko{\c c}abas and Vollmer, {William M.} and Thorarrin Gislason and Guy Marks and Koul, {Parvaiz A.} and Imed Harrabi and Louisa Gnatiuc and Sonia Buist and {the Burden of Obstructive Lung Disease (BOLD) Study} and Zhong, {Nan Shan} and Shengming Liu and Jiachun Lu and Pixin Ran and Dali Wang and Jingping Zheng and Yumin Zhou and Attila Hancioglu and Ismail Hanta and Sedat Kuleci and Turkyilmaz, {Ahmet Sinan} and Sema Umut and Turgay Unalan and Torkil Dawes and Bernd Lamprecht and Lea Schirhofer and Desiree Adams and Edward Barnes and Jasper Freeman and Anton Hayes and Sipho Hlengwa and Christine Johannisen and Mariana Koopman and Innocentia Louw and Ina Ludick and Alta Olckers and Johanna Ryck and Janita Storbeck and Bryndis Benedikdtsdottir and Kristin J{\"o}rundsdottir and Lovisa Gudmundsdottir and Sigrun Gudmundsdottir and Gunnar Gundmundsson and Jakub Frey and Rafal Harat and Filip Mejza and Pawel Nastalek and Andrzej Pajak and Wojciech Skucha and Andrzej Szczeklik and Magda Twardowska and Tobias Welte and Isabelle Bodemann and Henning Geldmacher and Alexandra Schweda-Linow and Amund Gulsvik and Tina Endresen and Lene Svendsen and Wen Wang and Mannino, {David M.} and John Cain and Rebecca Copeland and Dana Hazen and Jennifer Methvin and Dantes, {Renato B.} and Lourdes Amarillo and Berratio, {Lakan U.} and Fernandez, {Lenora C.} and Francisco, {Norberto A.} and Garcia, {Gerard S.} and {De Guia}, {Teresita S.} and Idolor, {Luisito F.} and Naval, {Sullian S.} and Thessa Reyes and Roa, {Camilo C.} and Sanchez, {Ma Flordeliza} and Simpao, {Leander P.} and Christine Jenkins and Tessa Bird and Paola Espinel and Kate Hardaker and Brett Toelle and Burney, {Peter G. J.} and Caron Amor and James Potts and Michael Tumilty and Fiona McLean and Wouters, {E. F. M.} and Wesseling, {G. J.} and Cristina B{\'a}rbara and F{\'a}tima Rodrigues and Herm{\'i}nia Dias and Jo{\~a}o Cardoso and Jo{\~a}o Almeida and Matos, {Maria Jo{\~a}o} and Paula Sim{\~a}o and Moutinho Santos and Reis Ferreira and Olafsdottir, {Inga Sif} and Katarina Nisser and Ulrike Spetz-Nystr{\"o}m and Gunilla H{\"a}gg and Lund, {Gun Marie} and Rain J{\~o}gi and Hendrik Laja and Katrin Ulst and Vappu Zobel and Lill, {Toomas Julius} and Sajjad Malik and Hakim, {Nissar A.} and Khan, {Umar Hafiz} and Rohini Chowgule and Vasant Shetye and Jonelle Raphael and Rosel Almeda and Mahesh Tawde and Rafiq Tadvi and Sunil Katkar and Milind Kadam and Rupesh Dhanawade and Umesh Ghurup and Myriam Denguezli and Zouhair Tabka and Hager Daldoul and Zaki Boukheroufa and Firas Chouikha and Khalifa, {Wahbi Belhaj} and Ayuyao, {Fernando G.} and Tady, {Cecil Z.} and Tan, {Daniel T.} and Sylvia Banal-Yang and Balanag, {Vincent M.} and Reyes, {Maria Teresita N.} and Sundeep Salvi and Siddhi Hirve and Bill Brashier and Jyoti Londhe and Sapna Madas and Somnath Sambhudas and Bharat Chaidhary and Meera Tambe and Savita Pingale and Arati Umap and Archana Umap and Nitin Shelar and Sampada Devchakke and Sharda Chaudhary and Suvarna Bondre and Savita Walke and Ashleshsa Gawhane and Anil Sapkal and Rupali Argade and Vijay Gaikwad and Crapo, {R. O.} and Jensen, {R. L.} and Paul Enright and Georg Harnoncourt",

note = "Version archived for private and non-commercial use with the permission of the author/s and according to publisher conditions. For further rights please contact the publisher.",

year = "2014",

month = may,

day = "1",

doi = "10.1136/thoraxjnl-2013-204460",

language = "English",

volume = "69",

pages = "465--473",

journal = "Thorax",

issn = "0040-6376",

publisher = "BMJ Publishing Group",

number = "5",

}

Burney, PGJ, Jithoo, A, Kato, B, Janson, C, Mannino, DM, Nizankowska-Mogilnicka, E, Studnicka, M, Tan, WC, Bateman, E, Koçabas, A, Vollmer, WM, Gislason, T, Marks, G, Koul, PA, Harrabi, I, Gnatiuc, L, Buist, S & the Burden of Obstructive Lung Disease (BOLD) Study 2014, 'Chronic obstructive pulmonary disease mortality and prevalence: the associations with smoking and poverty - a BOLD analysis', Thorax, vol. 69, no. 5, pp. 465-473. https://doi.org/10.1136/thoraxjnl-2013-204460

TY - JOUR

T1 - Chronic obstructive pulmonary disease mortality and prevalence

T2 - the associations with smoking and poverty - a BOLD analysis

AU - Burney, Peter G. J.

AU - Jithoo, Anamika

AU - Kato, Bernet

AU - Janson, Christer

AU - Mannino, David M.

AU - Nizankowska-Mogilnicka, Ewa

AU - Studnicka, Michael

AU - Tan, Wan C.

AU - Bateman, Eric

AU - Koçabas, Ali

AU - Vollmer, William M.

AU - Gislason, Thorarrin

AU - Marks, Guy

AU - Koul, Parvaiz A.

AU - Harrabi, Imed

AU - Gnatiuc, Louisa

AU - Buist, Sonia

AU - the Burden of Obstructive Lung Disease (BOLD) Study

AU - Zhong, Nan Shan

AU - Liu, Shengming

AU - Lu, Jiachun

AU - Ran, Pixin

AU - Wang, Dali

AU - Zheng, Jingping

AU - Zhou, Yumin

AU - Hancioglu, Attila

AU - Hanta, Ismail

AU - Kuleci, Sedat

AU - Turkyilmaz, Ahmet Sinan

AU - Umut, Sema

AU - Unalan, Turgay

AU - Dawes, Torkil

AU - Lamprecht, Bernd

AU - Schirhofer, Lea

AU - Adams, Desiree

AU - Barnes, Edward

AU - Freeman, Jasper

AU - Hayes, Anton

AU - Hlengwa, Sipho

AU - Johannisen, Christine

AU - Koopman, Mariana

AU - Louw, Innocentia

AU - Ludick, Ina

AU - Olckers, Alta

AU - Ryck, Johanna

AU - Storbeck, Janita

AU - Benedikdtsdottir, Bryndis

AU - Jörundsdottir, Kristin

AU - Gudmundsdottir, Lovisa

AU - Gudmundsdottir, Sigrun

AU - Gundmundsson, Gunnar

AU - Frey, Jakub

AU - Harat, Rafal

AU - Mejza, Filip

AU - Nastalek, Pawel

AU - Pajak, Andrzej

AU - Skucha, Wojciech

AU - Szczeklik, Andrzej

AU - Twardowska, Magda

AU - Welte, Tobias

AU - Bodemann, Isabelle

AU - Geldmacher, Henning

AU - Schweda-Linow, Alexandra

AU - Gulsvik, Amund

AU - Endresen, Tina

AU - Svendsen, Lene

AU - Wang, Wen

AU - Mannino, David M.

AU - Cain, John

AU - Copeland, Rebecca

AU - Hazen, Dana

AU - Methvin, Jennifer

AU - Dantes, Renato B.

AU - Amarillo, Lourdes

AU - Berratio, Lakan U.

AU - Fernandez, Lenora C.

AU - Francisco, Norberto A.

AU - Garcia, Gerard S.

AU - De Guia, Teresita S.

AU - Idolor, Luisito F.

AU - Naval, Sullian S.

AU - Reyes, Thessa

AU - Roa, Camilo C.

AU - Sanchez, Ma Flordeliza

AU - Simpao, Leander P.

AU - Jenkins, Christine

AU - Bird, Tessa

AU - Espinel, Paola

AU - Hardaker, Kate

AU - Toelle, Brett

AU - Burney, Peter G. J.

AU - Amor, Caron

AU - Potts, James

AU - Tumilty, Michael

AU - McLean, Fiona

AU - Wouters, E. F. M.

AU - Wesseling, G. J.

AU - Bárbara, Cristina

AU - Rodrigues, Fátima

AU - Dias, Hermínia

AU - Cardoso, João

AU - Almeida, João

AU - Matos, Maria João

AU - Simão, Paula

AU - Santos, Moutinho

AU - Ferreira, Reis

AU - Olafsdottir, Inga Sif

AU - Nisser, Katarina

AU - Spetz-Nyström, Ulrike

AU - Hägg, Gunilla

AU - Lund, Gun Marie

AU - Jõgi, Rain

AU - Laja, Hendrik

AU - Ulst, Katrin

AU - Zobel, Vappu

AU - Lill, Toomas Julius

AU - Malik, Sajjad

AU - Hakim, Nissar A.

AU - Khan, Umar Hafiz

AU - Chowgule, Rohini

AU - Shetye, Vasant

AU - Raphael, Jonelle

AU - Almeda, Rosel

AU - Tawde, Mahesh

AU - Tadvi, Rafiq

AU - Katkar, Sunil

AU - Kadam, Milind

AU - Dhanawade, Rupesh

AU - Ghurup, Umesh

AU - Denguezli, Myriam

AU - Tabka, Zouhair

AU - Daldoul, Hager

AU - Boukheroufa, Zaki

AU - Chouikha, Firas

AU - Khalifa, Wahbi Belhaj

AU - Ayuyao, Fernando G.

AU - Tady, Cecil Z.

AU - Tan, Daniel T.

AU - Banal-Yang, Sylvia

AU - Balanag, Vincent M.

AU - Reyes, Maria Teresita N.

AU - Salvi, Sundeep

AU - Hirve, Siddhi

AU - Brashier, Bill

AU - Londhe, Jyoti

AU - Madas, Sapna

AU - Sambhudas, Somnath

AU - Chaidhary, Bharat

AU - Tambe, Meera

AU - Pingale, Savita

AU - Umap, Arati

AU - Umap, Archana

AU - Shelar, Nitin

AU - Devchakke, Sampada

AU - Chaudhary, Sharda

AU - Bondre, Suvarna

AU - Walke, Savita

AU - Gawhane, Ashleshsa

AU - Sapkal, Anil

AU - Argade, Rupali

AU - Gaikwad, Vijay

AU - Crapo, R. O.

AU - Jensen, R. L.

AU - Enright, Paul

AU - Harnoncourt, Georg

N1 - Version archived for private and non-commercial use with the permission of the author/s and according to publisher conditions. For further rights please contact the publisher.

PY - 2014/5/1

Y1 - 2014/5/1

N2 - 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 rs=0.73, p=0.0001; women rs=0.90, p<0.0001; 60+ years: men rs=0.63, p=0.0022; women rs=0.37, p=0.1) than obstruction (<60 years: men rs=0.28, p=0.20; women rs=0.17, p<0.46; 60+ years: men rs=0.28, p=0.23; women rs=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.

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

UR - http://www.scopus.com/inward/record.url?scp=84898655103&partnerID=8YFLogxK

U2 - 10.1136/thoraxjnl-2013-204460

DO - 10.1136/thoraxjnl-2013-204460

M3 - Article

C2 - 24353008

AN - SCOPUS:84898655103

SN - 0040-6376

VL - 69

SP - 465

EP - 473

JO - Thorax

JF - Thorax

IS - 5

ER -

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

Abstract

Bibliographical note

Access to Document

Other files and links

Fingerprint

Cite this