Chronic obstructive pulmonary disease overview: prevalence, pathogenesis, and treatment.

OBJECTIVE To discuss the current clinical data on the prevalence, pathogenesis, staging, and treatment of chronic obstructive pulmonary disease (COPD). DATA SOURCES This article reviews the results of published studies and presents data from current guidelines and expert opinion. CONCLUSIONS An insidious disorder that is asymptomatic early, COPD (the preferred term for patients with chronic bronchitis and emphysema) prevalence has increased in recent decades, adding a significant burden to patients and the health care system. COPD, an inflammatory disorder secondary to the chronic inhalation of principally tobacco smoke, induces a progressive deterioration in pulmonary function with a marked increase in morbidity and mortality over time. The signs and symptoms of COPD, which appear in many patients only after forced expiratory volume in 1 second (FEV1) is <50% predicted, should not be confused with asthma, because these two diseases display grossly different inflammatory processes, etiologies, clinical courses, responses to treatment, and outcomes. The effective management of COPD relies primarily on early identification, changing smoking habits, and the use of bronchodilators to improve pulmonary function, symptoms, acute exacerbation rate, quality of life, mortality, and comorbidities. With early detection and aggressive treatment, the natural history of this disease can be improved. Office spirometry for all smokers and ex-smokers as well as those with respiratory symptoms is mandatory as a means of achieving early diagnosis and improving long-term outcomes.