The Forgotten Killer

Chronic Obstructive Pulmonary Disease (COPD) is called the forgotten killer and is currently the fourth leading cause of death in the United States and the fifth leading cause of death in the world.  In Canada, it kills more women than breast cancer.  And throughout North America, it’s the only common cause of death still increasing in prevalence.  Yet when is the last time you heard of a fundraiser to fight off this forgotten killer?

COPD is a collection of chronic lung diseases, including emphysema and chronic bronchitis, that clocks the airways and restricts oxygen flow throughout the body.  The condition has long been linked with cigarette smoking, and smoking does remain its top cause.  But researchers now know that some cases of COPD are also the result of exposure to dust, fumes, and secondhand smoke; decades of living with asthma; poor diet; and even a wily bacteria that shifts just enough to continually outwit the antibiotics used to vanquish it.
 
Researcher also think COPD is more than just a disease of the lungs.  In an editorial in the British medical Journal The Lancet, doctors from the Netherlands and Italy suggested that in many people, COPD is part of a cluster of conditions, all related to chronic inflammation in the body.  This systemic inflammation is likely responsible for the high blood pressure, diabetes, coronary artery disease, heart failure, and even cancer that tend to exist along with COPD.  They recommend that people with at least three of the following be diagnosed with what they call Chronic Systemic Inflammation syndrome, not just a single disease:

• Smoking for more than 10 pack-years (the equivalent of smoking 1 pack a day for 10 years; or 2 packs a day for 5 years)
• Symptoms and abnormal lung function of COPD
• Chronic Heart Failure
• Metabolic Syndrome
• Increased levels of C-reactive protein, an inflammatory marker, in the bloodstream.

​Other evidence that COPD is often part of a broader syndrome comes from researchers in Great Britain, who found that people with the disease develop arterial stiffness, or atherosclerosis, far earlier than those without COPD.  The researchers also found high levels of inflammatory chemicals in the arteries of people with COPD.  All of which adds up to one thing:  COPD, whether on its own or part of a cluster of conditions, is scary stuff.

Symptoms of COPD include breathing difficulty, cough, mucus (sputum) production and wheezing. COPD symptoms often don't appear until significant lung damage has occurred, and they usually worsen over time, particularly if smoking exposure continues. For chronic bronchitis, the main symptom is a daily cough and mucus (sputum) production at least three months a year for two consecutive years.

Other signs and symptoms of COPD may include:

• Shortness of breath, especially during physical activities
• Wheezing
• Chest tightness
• Having to clear your throat first thing in the morning, due to excess mucus in your lungs
• A chronic cough that may produce mucus (sputum) that may be clear, white, yellow or greenish
• Blueness of the lips or fingernail beds (cyanosis)
• Frequent respiratory infections
• Lack of energy
• Unintended weight loss (in later stages)
• Swelling in ankles, feet or legs

 
People with COPD are also likely to experience episodes called exacerbations, during which their symptoms become worse than usual day-to-day variation and persist for at least several days.

The good news is that COPD is preventable and is treatable.  In my next blog I will give you 5 ways to prevent COPD, so come back on Monday to find out what they are.