Among chronic respiratory diseases, Chronic Obstructive Pulmonary Disease (COPD) is the most prevalent, affecting more than 300 million people worldwide. In 2019, 3.3 million people lost their lives, as reflected by the Spanish Society of Pulmonology and Thoracic Surgery (SEPAR) on World COPD Day.
The COPD is a respiratory disease produced by the inhalation of a toxic substance, usually tobacco, which makes it difficult for air to pass through the bronchi, causing an obstruction of the respiratory tract. Specifically, the 80% of the patients have been smokers.
In Spain, from the age of 40 it is located in 33.9 cases per 1,000 inhabitants, more than twice as many men. Although there are more and more women who present this pathology according to the Spanish Society of Internal Medicine (SEMI).
And the prevalence of this pathology increases progressively until reaching the highest frequency in the age group of 80 to 84 years.
“It is a disease that is usually accompanied by a high percentage of other diseases or comorbidities. The management of patients with COPD must not focus only on lung pathology, but an active search for these comorbidities is necessary,” explains the doctor María Gómez Antúnez, internist of the SEMI of the Internal Medicine Service of the Hospital General Universitari Gregorio Marañón de Madrid.
Comorbidities associated with COPD
According to doctor Belén Alonso, coordinator of the COPD Working Group of SEMI and internist at the Gran Canaria University Hospital Doctor Negrín de Las Palmas in Gran Canaria“comorbidities in patients with COPD are more frequent in older people, in those with more advanced lung disease, and in those hospitalized for an acute exacerbation”.
The average number of comorbidities per patient is between 4 and 5.
Among the main comorbidities associated with this disease, stand out:
- Arterial hypertension.
- Dyslipidemia
- diabetes mellitus
- Heart failure.
- Atrial fibrillation.
- Ischemic cardiopathy.
- Chronic kidney disease.
- Peripheral arterial disease.
- osteoporosis
Five phenotypes
On the other hand, SEPAR points out that it is important to address COPD with a new approach based on five phenotypes according to the predominant risk factor of this disease.
Thus, he has drawn up a document with experts in the disease and with the magazine The Lancet.
“Pneumologists consider it urgent and vital to remember that COPD is a heterogeneous disease, caused by different risk factors, not only by tobacco”, explains the doctor Javier de Miguel, pulmonologist and coordinator of the COPD Area of SEPAR.
“It will help us to suspect cases in people who do not respond to the classic smoker phenotype and to decide the optimal treatment for each patient profile,” he adds.
The five phenotypes in which COPD is manifested and classified are:
- The geneticsdue to alpha-1-antitrypsin deficiency.
- Events in early stages of lifesuch as prematurity (associated with poor lung function) and exposure to tobacco at these stages.
- Infectionssuch as having pneumonia in childhood, tuberculosis or having HIV.
- The tobacco and the cigarettes (vaping is not harmless), and the risk of developing this disease is doubled when smoking combustible cigarettes is combined with e-cigarettes.
- Environmental exposurewhich covers exposure to particulates and gases from indoor fuel use, wildfire smoke, air pollution or toxic mist, and occupational exposure to various vapours, dusts, gases and fumes.
Tests for an early diagnosis
In order to detect this disease in time, the chemical-pharmaceutical company Esteve Tejin launches diagnostic tests in different cities together with the pneumology services of the main hospitals where it operates.
An action to raise awareness of COPD, as early diagnosis and appropriate treatment can delay its progression.
The diagnosis of the disease can be carried out in several ways forms:
- Making one spirometry. It is the most common test and evaluates the functioning of the lungs, measuring the amount of air inhaled, exhaled, and the speed of exhalation, which allows the disease to be detected before symptoms are recognized.
- Measurement of oxygen in the blood through oximetry. In people who have a lung disorder, the levels of oxygen in their blood can be lower than normal and this can affect the heart and brain.
- New tests like TACto detect this disease even earlier.