Change search
ReferencesLink to record
Permanent link

Direct link
Chronic obstructive pulmonary disease mortality and prevalence: the associations with smoking and poverty-a BOLD analysis
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Respiratory Medicine and Allergology.
Show others and affiliations
2014 (English)In: Thorax, ISSN 0040-6376, E-ISSN 1468-3296, Vol. 69, no 5, 465-473 p.Article in journal (Refereed) Published
Abstract [en]

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

Place, publisher, year, edition, pages
2014. Vol. 69, no 5, 465-473 p.
National Category
Respiratory Medicine and Allergy
URN: urn:nbn:se:uu:diva-227276DOI: 10.1136/thoraxjnl-2013-204460ISI: 000334397800010OAI: diva2:730839
Available from: 2014-06-30 Created: 2014-06-24 Last updated: 2014-06-30Bibliographically approved

Open Access in DiVA

fulltext(1073 kB)252 downloads
File information
File name FULLTEXT01.pdfFile size 1073 kBChecksum SHA-512
Type fulltextMimetype application/pdf

Other links

Publisher's full text

Search in DiVA

By author/editor
Janson, Christer
By organisation
Respiratory Medicine and Allergology
In the same journal
Respiratory Medicine and Allergy

Search outside of DiVA

GoogleGoogle Scholar
Total: 252 downloads
The number of downloads is the sum of all downloads of full texts. It may include eg previous versions that are now no longer available

Altmetric score

Total: 222 hits
ReferencesLink to record
Permanent link

Direct link