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Chronic obstructive pulmonary disease (COPD) is a group of progressive lung diseases that obstruct airflow.

COPD is a leading cause of death in the United States, affecting 16 million Americans and millions more who don’t know they have it.

It’s characterized by increasing breathlessness, with symptoms developing slowly. Though there’s currently no cure for COPD, it’s often preventable and treatable. The most common cause is smoking.

More than 65 million people around the world have moderate or severe COPD, and experts predict that this number will continue to rise worldwide over the next 50 years.

With proper management, however, most people with COPD can achieve good symptom control and quality of life, as well as reduce their risk of other associated conditions including heart disease and lung cancer.

Read on for more information on the causes and symptoms of COPD, as well as treatment options and more.

COPD types and frequency

In the past, doctors were more likely to tell their patients that they had chronic bronchitis or emphysema than to use the more general term COPD, which encompasses a fuller range of chronic obstructive lung diseases.

Both emphysema and chronic bronchitis are the two most common types of COPD.

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Chronic bronchitis

Bronchitis is inflammation of the bronchi, the air pathways to the lungs.

In 2016, more than 8.9 million Americans were diagnosed with chronic bronchitis and nearly 75 percent of cases involved people over the age of 45.

In the United States, women have chronic bronchitis at almost double the rate of men. In 2016, 5.9 million women had been diagnosed with chronic bronchitis in the past 12 months, as opposed to 3 million men who had been diagnosed during this time.

There are some differences among races, too. Figures from 2016 also showed that non-Hispanic whites and African Americans were more likely to have been diagnosed with chronic bronchitis.

Emphysema

Emphysema causes damage to the alveoli, the air sacs in your lungs. The walls of the damaged air sacs become stretched out and your lungs actually get bigger, making it harder to move your air in and out.

About 3.5 million Americans have been diagnosed with emphysema, with more than 90 percent of cases involving people over age 45.

By 2016, 1.6 million women and 1.8 million men had emphysema.

Prevalence

In 2015, 3.2 million people died from COPD worldwide, an increase of 11.6 percent compared with 1990. During that same time period, the prevalence of COPD increased by 44.2 percent to 174.5 million individuals.

In the United States, an estimated 16 million adults have COPD. However, that may be an underestimate. The American Lung Association (ALA) thinks there may be as many as 24 million American adults living with COPD.

Rates of COPD are highest in the Southeast and Midwest states. In 2015, the rate was as low as 3.8 percent in only one state — Utah. In West Virginia, the highest, it was 12 percent.

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COPD was the fourth-leading cause of death in the United States in 2016, following heart disease, cancer, and unintentional injuries.

Women have higher rates of COPD than men throughout most of their lifespan, although it appears that they’re especially vulnerable before the age of 65.

Worldwide, COPD was previously more common in men but the disease now affects men and women equally. In the United States, women are still 37 percent more likely to have COPD than men.

More than 7 million U.S. women have COPD, and millions more are believed to have symptoms, yet haven’t been diagnosed.

You can get it at any age, but middle-aged and older adults are most likely to be diagnosed with COPD.

Causes

Most COPD is caused by smoking. However, only one in five smokers will get significant COPD.

COPD can also occur in those who’ve had long-term exposure and contact with harmful pollutants in their workplace. Some of these harmful lung irritants include certain chemicals, dust, or fumes. Another cause is exposure to chemical fumes.

Heavy or long-term contact with secondhand smoke or other lung irritants in the home, such as organic cooking fuel, may also cause COPD.

Rarely, it’s caused by something called alpha-1-antitrypsin (AAT) deficiency. It’s a genetic condition that causes low levels of the AAT protein, which helps to protect the lungs. According to the Mayo Clinic, it’s the cause of about 1 percent of COPD cases. Genetics, air pollution, and recurrent respiratory infections may be contributing factors.

Symptoms

Early symptoms of COPD are easy to ignore. They include shortness of breath or tiring easily.

Later, you may develop a cough. The cough may produce mucus, phlegm, or spots of blood. Fatigue and tightness in the chest can become a problem. Physical exertion like climbing a flight of stairs may leave you wheezing or gasping for air.

As COPD progresses, there may be swelling in the legs and feet. Low oxygen levels in your bloodstream may result in gray or blue discoloration of your lips and fingernails. You may also experience increased weight loss.

Common signs and symptoms include:

  • constant coughing, sometimes referred to as a “smoker’s cough”
  • shortness of breath while doing everyday activities
  • an inability to breath easily or take a deep breath
  • excess mucus production coughed up as sputum
  • wheezing
  • blueness of the lips or fingernail beds
  • frequent respiratory infections
  • lack of energy

Someone may have COPD but not notice symptoms until the disease is in its moderate stage. This is why it’s important to ask your doctor about taking a noninvasive spirometry test, which measures how well your lungs are working, if:

  • you’re a current or former smoker
  • have been exposed to harmful lung irritants for a long period of time
  • have a history of COPD in your family

Treatment and complications

Treatment can often successfully manage symptoms of COPD, but it’s a serious condition.

Current treatments for COPD cannot repair the damage to your lungs, but some treatments may reduce your risk of flare-ups. This makes it easier for you to breathe and feel better.

The goals of COPD treatment include:

  • relieving your symptoms
  • slowing the progress of the disease
  • improving your exercise tolerance or your ability to stay active
  • preventing and treating complications
  • improving your overall health

The most essential step in any treatment plan for COPD is to stop all smoking. Quitting smoking isn’t easy, but nicotine replacement products and medications might help.

Other treatment options include bronchodilators, which relax the muscles around the airways, and pulmonary rehabilitation, a broad program that helps improve the well-being of people who have chronic breathing problems.

If you have COPD, you’re more vulnerable to the common cold, influenza, and pneumonia. COPD also increases your risk of developing pulmonary hypertension, which is high blood pressure in the arteries that serve the lungs.

Other complications from COPD include:

  • respiratory infections
  • heart problems
  • lung cancer
  • high blood pressure in the lung arteries
  • depression

Survival rates

The World Health Organization (WHO) reported that more than 3 million people died due to COPD in 2015. That represents 5 percent of all deaths worldwide.

About 90 percent of those deaths took place in low or middle-income regions.

Smoking is linked to up to 90 percent of all COPD deaths in the United States. A growing body of evidence suggests that women may be biologically more susceptible to the lung damage caused by tobacco smoke and environmental pollutants.

The number of deaths from COPD among women has quadrupled since 1980. By the year 2000, COPD had claimed the lives of more women than men for the first time, and women now account for roughly 53 percent of all U.S. deaths attributed to COPD.

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In women, smokers are 22 times more likely to die from COPD than nonsmoking women. For men, smokers are 26 times more likely to die from COPD than their nonsmoking counterparts.

The age-adjusted death rate declined for both white and black men but remained stable for white women and increased for black women from 2000 through 2014.

Cost

COPD is costly, and results in a high rate of hospitalizations for people over age 65.

More than $32 billion was spent on COPD-related patient care in 2010, and those costs are projected to increase to $49 billion by 2020.

According to the ALA, a survey of people with COPD showed that as many as 51 percent were limited in their ability to function at work. Seventy percent said it limits physical activity. Fifty-six percent said household chores were a problem and 50 percent had trouble sleeping. Fifty-three percent also felt limited in social activities while 46 percent felt it interfered with family activities.