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COPD
Chronic obstructive pulmonary disease is a type of progressive lung disease characterized by long-term respiratory symptoms and airflow limitation.
GOLD 2024 defined COPD as a heterogeneous lung condition characterized by chronic respiratory symptoms due to abnormalities of the airways and/or alveoli that cause persistent, often progressive, airflow obstruction. The main symptoms of COPD include shortness of breath and a cough, which may or may not produce mucus. COPD progressively worsens, with everyday activities such as walking or dressing becoming difficult. While COPD is incurable, it is preventable and treatable. The two most common types of COPD are emphysema and chronic bronchitis and have been the two classic COPD phenotypes. However, this basic dogma has been challenged as varying degrees of co-existing emphysema, chronic bronchitis, and potentially significant vascular diseases have all been acknowledged in those with COPD, giving rise to the classification of other phenotypes or subtypes.

According to the latest data from the UK Office for National Statistics, approximately 1.2 million people are officially diagnosed with COPD in the UK, although it is estimated that a substantial number remain undiagnosed. COPD is the second leading cause of lung disease-related deaths in the country. The disease significantly impacts the quality of life, often leading to progressive disability and increased healthcare utilization due to frequent exacerbations.

The primary risk factor for COPD is smoking, accounting for approximately 80% of cases. While the smoking prevalence has declined over the years due to effective public health campaigns, the legacy of tobacco use continues to affect many older adults. Other risk factors include long-term exposure to indoor and outdoor air pollution, occupational dust and chemicals, as well as genetic factors such as alpha-1 antitrypsin deficiency.

Patients with COPD typically present with symptoms such as chronic cough, sputum production, and progressive dyspnea (shortness of breath). Diagnosis is usually made through a combination of clinical evaluation, patient history, and spirometry—a non-invasive test that measures lung function. Early diagnosis is essential for effective management and can significantly slow disease progression.

Management of COPD in the UK focuses on reducing symptoms, improving quality of life, and minimizing exacerbations. This is achieved through a multifaceted approach that includes smoking cessation, pharmacological treatments (such as bronchodilators and corticosteroids), pulmonary rehabilitation, and, in some cases, surgery. Recent advancements in treatment options, including biologics and new inhalation therapies, are providing more tailored approaches to patient care.