Saturday , May 8 2021

COPD: the reason for the high rate of disease underdiagnosis that causes 3 million deaths per year



Chronic obstructive pulmonary disease (COPD) is a pathology characterized by limitation of airway air flow product abnormalities caused by exposure to the most dangerous gases are tobacco smoke.

Although it is less common that bronchial asthma (the most common chronic respiratory disease) has a mortality rate eight times higher. It should be noted that this is a common, preventable and treatable condition, and its prevalence is directly related to smoking, although in other developing countries, other factors such as wood smoke, history of respiratory infections in childhood or exposure to other types of gas are also considered.

Epidemiological studies from several years ago revealed that there are around 350 million people in the world with COPD – what is in accordance with the prevalence of 11% of the world population – and that this disease causes around three million deaths per year (5, 6% of world deaths) , which places it as the fourth leading cause of death in the world.

In addition, there is an increase in cases worldwide from the estimated value of 149 million subjects in 2005 to 174.5 million in 2015, which means a 17% increase in overall prevalence. If this trend continues, it is expected that by 2030 the number will increase to 4.5 million deaths.

With regard to Argentina, the only study that provides data on this is COPD.AR. According to the results, this disease has a 14.5% prevalence in local residents over 40 years and occurs more in men (18%) than in women (11%).

Of the population studied randomly, 70% had an active smoking history or former smokers and in the non-smoking population, 8% indicated the prevalence of COPD in relation to a history of passive smoking, uncontrolled pulmonary tuberculosis or bronchial asthma in childhood.

In turn, high levels of underdiagnosis are indicated because only 22% of the subjects diagnosed in this study were known as patients with COPD.

"The possibility of COPD should be suspected in any patient over the age of 40 with a history of smoking who smoked more than 10 packs per year and who had chronic respiratory symptoms such as dyspnea or usually morning cough and expectations," said pulmonologist. Gastón De Stefano.

Specialists from the Institute of Neurosciences Buenos Aires (Ineba) insist that "it is important to consider that smokers play down their symptoms, which is why strict monitoring of them must be done for all smokers at the age of 40."

To be able to diagnose COPD, spirometry is the most widely used method. This consists of a study that makes it possible to detect a barrier against continuous air flow and thus can make it from mild to very severe.

"For your treatment there are different pharmacological choices -bronchodilators – short or prolonged actions and inhaled corticosteroids – as well as other steps that help to relieve them – said specialists. There are also innovative treatments who are still in the experimental stage, even though none of them cure or change the course of the disease, they only relieve symptoms and reduce the frequency of exacerbations ".

In addition to drugs, what can be done to treat COPD? "First of all, the main thing is to stop smoking, this is the most effective step, it delay the loss of lung function and improve survival, change the course of the disease," said De Stefano, who also recommends:

– Don't use electronic cigarettes to stop smoking. It is important to explain that although many people use it, this device is prohibited by the Society of Pneumonology as a method of stopping smoking because they have toxins and maintain the habit.

– Exercise regularly. Can be gymnastics, sports, or traveling. Both smokers and not, moving reduces the risk of developing future illnesses. For patients who remain symptomatic after spending all therapeutic measures, a rehabilitation program can also be indicated, which then must be continued with exercise at home.

– Eat well. Maintaining a varied and balanced diet (nutritional supplements are not recommended) and good hydration.

– Vaccination Having an annual flu shot has been shown to reduce exacerbations. In turn, patients aged 65 and younger at this age, but with advanced stages of the disease, must receive a pneumococcal vaccine.

"The current trend is the individual management of patients with COPD, using different pharmacological strategies for each patient according to their symptoms, but without forgetting the most important general measures that must be applied to all patients – changing the evolution and prognosis of smoking cessation. high level of underdiagnosis and limited use of spirometry as a screening method requires a larger health strategy for greater awareness of disease in the population, "concluded the pulmonologist.

On occasion World COPD Day, which is celebrated today, will be held until 30 November free spirometry in Health and Death Research. To request a turn, communicate Monday to Friday, from 9am to 16pm, at (011) 4514-3400 or personally at the Azcuénaga 1860, 1. floor, CABA.


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