TY - JOUR
T1 - Chronic obstructive pulmonary disease
T2 - NHLBI workshop on the primary prevention of chronic lung diseases
AU - Drummond, M. Bradley
AU - Buist, A. Sonia
AU - Crapo, James D.
AU - Wise, Robert A.
AU - Rennard, Stephen I.
PY - 2014/4
Y1 - 2014/4
N2 - Chronic obstructive pulmonary disease (COPD) is a complex set of conditions with multiple risk factors, disease mechanisms, and clinical manifestations. These characteristics make primary prevention of COPD challenging. Semantic issues related to prevalent and incident disease (e.g., the use of specific cut points on a continuous range) should not derail development of primary prevention initiatives. Potential targets for COPD prevention occur along the spectrum of disease development. Understanding risk factors early in life, whether specific to COPD or not, allows for study of interventions to optimize lung function at birth and to prolong the lung function plateau, potentially reducing the development of COPD. It is necessary to identify noninvasive ways to screen for early COPD in those at risk before progression to clinically significant disease. Identification of specific COPD subgroups, such as individuals with chronic bronchitis, those with α1-antitrypsin deficiency, or early radiographic changes with normal spirometry, may offer specific opportunities for primary prevention. A better understanding of why COPD progresses despite smoking cessation is needed. Future research initiatives should also focus on identifying the underlying mechanisms and relevant interventions for nonsmokers with COPD, a currently poorly studied group. Ultimately, preventing the development of COPD will serve to reduce the tremendous burden of this chronic disease worldwide.
AB - Chronic obstructive pulmonary disease (COPD) is a complex set of conditions with multiple risk factors, disease mechanisms, and clinical manifestations. These characteristics make primary prevention of COPD challenging. Semantic issues related to prevalent and incident disease (e.g., the use of specific cut points on a continuous range) should not derail development of primary prevention initiatives. Potential targets for COPD prevention occur along the spectrum of disease development. Understanding risk factors early in life, whether specific to COPD or not, allows for study of interventions to optimize lung function at birth and to prolong the lung function plateau, potentially reducing the development of COPD. It is necessary to identify noninvasive ways to screen for early COPD in those at risk before progression to clinically significant disease. Identification of specific COPD subgroups, such as individuals with chronic bronchitis, those with α1-antitrypsin deficiency, or early radiographic changes with normal spirometry, may offer specific opportunities for primary prevention. A better understanding of why COPD progresses despite smoking cessation is needed. Future research initiatives should also focus on identifying the underlying mechanisms and relevant interventions for nonsmokers with COPD, a currently poorly studied group. Ultimately, preventing the development of COPD will serve to reduce the tremendous burden of this chronic disease worldwide.
KW - Chronic obstructive pulmonary disease
KW - Primary prevention
UR - http://www.scopus.com/inward/record.url?scp=84899097221&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84899097221&partnerID=8YFLogxK
U2 - 10.1513/AnnalsATS.201312-432LD
DO - 10.1513/AnnalsATS.201312-432LD
M3 - Article
C2 - 24754824
AN - SCOPUS:84899097221
SN - 2325-6621
VL - 11
SP - S154-S160
JO - Annals of the American Thoracic Society
JF - Annals of the American Thoracic Society
IS - SUPPL. 3
ER -