Definition, epidemiology and natural history of COPD

G. Viegi, F. Pistelli, D. L. Sherrill, S. Maio, S. Baldacci, L. Carrozzi

Research output: Contribution to journalReview articlepeer-review

304 Scopus citations


Chronic obstructive pulmonary disease (COPD) is the fifth cause of morbidity and mortality in the developed world and represents a substantial economic and social burden. Patients experience a progressive deterioration up to end-stage COPD, characterised by very severe airflow limitation, severely limited and declining performance status with chronic respiratory failure, advanced age, multiple comorbidities and severe systemic manifestations/ complications. COPD is frequently underdiagnosed and under-treated. Today, COPD develops earlier in life and is less gender specific. Tobacco smoking is the major risk factor for COPD, followed by occupation and air pollution. Severe deficiency for α1-antitrypsin is rare; several phenotypes are being associated with elevated risk for COPD in the presence of risk factor exposure. Any patient presenting with cough, sputum production or dyspnoea should be assessed by standardised spirometry. Continued exposure to noxious agents promotes a more rapid decline in lung function and increases the risk for repeated exacerbations, eventually leading to end-stage disease. Without major efforts in prevention, there will be an increasing proportion of end-stage patients who can live longer through long-term oxygen therapy and assisted ventilation, but with elevated suffering and huge costs. Smoking prevention and smoking cessation are the most important epidemiological measurements to counteract chronic obstructive pulmonary disease epidemics. Copyright

Original languageEnglish (US)
Pages (from-to)993-1013
Number of pages21
JournalEuropean Respiratory Journal
Issue number5
StatePublished - Nov 2007


  • Air pollution
  • Chronic obstructive pulmonary disease clinical/basic investigations
  • Cor pulmonale
  • Epidemiology of asthma/chronic obstructive pulmonary disease
  • Smoking
  • Spirometry

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine


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