COPD: A Leading Killer in Oklahoma and the U.S.

It is estimated that 30 million individuals in the U.S. have been affected by Chronic Obstructive Pulmonary Disease (COPD); however, only 15 million of those individuals have been officially diagnosed with the disease.  As one of the leading causes of death in both Oklahoma and the United States, COPD goes undiagnosed or mistaken for other lung conditions more often than not.

What is COPD?

Chronic Obstructive Pulmonary Disease is a progressive and life-threatening lung disease that makes it difficult to breathe. COPD is not just one disease, but actually, an umbrella term used to describe multiple lung diseases including chronic bronchitis, severe asthma, emphysema and some forms of bronchiectasis.

The term progressive means that COPD symptoms worsen over time. Common symptoms include coughing that produces large amounts of mucus, wheezing, shortness of breath and chest tightness. If left untreated or undiagnosed, COPD can be fatal in extreme cases.

Many people mistake symptoms associated with COPD as common side effects of aging and don’t seek medical treatment when they begin to experience shortness of breath. Unfortunately, COPD can develop for years before symptoms start to present themselves, meaning those who ignore their symptoms for long periods may actually have significant lung damage without realizing it. For this reason, it’s important to consult your doctor or primary care physician as soon as you begin to experience symptoms of COPD. They can recommend treatment methods to manage your condition and prevent the progression of the disease.

A leading cause of death in the United States

The Centers for Disease Control and Prevention reports chronic lower respiratory diseases, primarily COPD, as the third leading cause of death in the United States, behind heart disease and cancer respectively. On a global scale, COPD was responsible for 3 million, or 5 percent, of deaths worldwide in 2015. The number of diagnosed cases of COPD is expected to increase in coming years due to a higher prevalence of smoking and aging populations worldwide.

In Oklahoma, COPD is also ranked as the third leading cause of death followed by unintentional injury and stroke. In 2016, approximately 8 percent of Oklahoma residents were diagnosed with COPD.

Who is at risk for COPD?

The primary cause of COPD is the active smoking of cigarettes, pipes, cigars or other smoking devices. COPD was once thought to be a “man’s disease,” but due to high levels of tobacco use among women and their increased risk of exposure to indoor air pollutants, women are now more likely than men to be diagnosed with the disease.

According to the American Lung Association, women are more vulnerable to lung damage and diseases. Women’s lungs are smaller and the female hormone estrogen plays a role in worsening lung disease. As of last year, 9.2 percent of women in Oklahoma have COPD, compared to only 7.2 percent of Oklahoma men. 

The CDC reports that the following populations are at a greater risk to be diagnosed with COPD.

• People aged 65–75 years
• American Indian/Alaska Natives and multiracial non-Hispanics
• Women
• Individuals who were unemployed, retired or unable to work
• Individuals with less than a high school education
• Individuals who were divorced, widowed or separated
• Current or former smokers
• People with a history of asthma

Below are known factors linked to the development of COPD.

Smoking

The vast majority of people with COPD are either current or former smokers over the age of 40. In fact, approximately 85-90 percent of COPD cases are linked to active smoking and 14.2 percent of Oklahomans diagnosed with the disease still currently smoke.

Cigarettes and other tobacco products release more than 7,000 chemicals and toxins that can weaken your lungs’ defenses against infections.  Smoke inhalation can also narrow your air passages, causing air tubes to swell and destroy air sacs, all of which are contributing factors for COPD symptoms.

The Great American Smokeout

If you’re a consistent smoker, there’s no better time to quit smoking and reduce your risk of developing COPD. Every year, the American Cancer Society hosts The Great American Smokeout, a day set aside to motivate smokers to quit smoking outright or to create a plan to quit in the near future.  

The American Cancer Society shares that, “by quitting—even for one day—smokers will be taking an important step toward a healthier life.” Quitting smoking has both immediate and long-term benefits for individuals of any age, including decreasing their risk of developing lung cancer and other lung diseases like COPD.

Visit the American Cancer Society’s website to learn more about The Great American Smokeout and take your first step toward living a healthier life.

Environmental Factors

The second largest contributing factor for COPD is exposure to harmful environmental pollutants, either in the workplace, home or just in nature. In the workplace, exposure to irritants such as harmful chemicals, dust or fumes have been linked to worsening lung conditions. At home, smoke or fumes originating from cooking or heating can also cause an increased risk for COPD.  Heavy air pollution and second-hand smoke are also contributing factors.

Genetic Factors

Although rare, there is a chance that those who have never smoked or been exposed to environmental pollutants can develop COPD. The Alpha-1 Antitrypsin Deficiency, also known as AATD, is the most commonly known genetic risk factor for developing emphysema. AATD-related emphysema is caused by a deficiency of the Alpha-1 Antitrypsin protein in the bloodstream. Without this protein, white blood cells attack and harm the lungs and contribute to deterioration that can lead to COPD and other breathing complications.

Signs and symptoms

The severity of COPD-related symptoms varies from person to person depending on the extent of their lung damage. For some, it can take years for symptoms to present themselves, while for others, symptoms may be noticed early on. The following are common symptoms and warning signs of lung damage and possible COPD.

• Shortness of breath: Having difficulty breathing, either while participating in physical activity or while not doing anything at all, is a common symptom of lung damage and COPD.
• Increase in mucus production: Increased mucus production from your lungs, not your sinuses, and any changes in color or texture can be a warning that your lungs are in distress.
• Frequent coughing with no explanation: Constant coughing not tied to another illness (such as the cold or flu) that persists for several weeks or longer or is accompanied by wheezing can be a sign of COPD.
• Waking up with head pain: Waking up with a headache could be a sign that your body isn’t getting enough oxygen while you’re asleep, causing carbon dioxide to build up in your bloodstream.
• Swollen ankles: A signal of more severe cases of COPD, swelling of the ankles, feet or legs can be caused when your blood vessels don’t get the oxygen they need, thus putting strain on your heart. This strain can make your lower extremities swell as fluid builds up.
• Sleep problems: Severe breathlessness and coughing can disrupt your sleep and cause you to wake up several times throughout the night. COPD is also known to co-occur with other conditions that make sleeping difficult, such as sleep apnea and gastroesophageal reflux disease (GERD).
• Fatigue: Fatigue is a common occurrence when you experience breathlessness. If fatigue is keeping you from participating in daily activities, it could be a sign of COPD.
• Unexplained weight loss: When your lungs have to work harder, you burn more calories when trying to breathe. For those with COPD, breathing can burn up to 10 times more calories than it does for people without the disease. COPD can also cause a decrease in your appetite, which can lead to weight loss.
• Difficulty breathing while lying down: COPD can make it extremely difficult to breathe while lying down.

If you experience any of these symptoms, it’s important to consult a health care professional as soon as possible to mitigate further lung damage.

Prevention and treatment

There is no cure for COPD. However, early detection can help you and your doctor treat and manage the disease. Treatment options can help relieve your symptoms and improve your quality of life.

If you notice signs of COPD, your doctor may recommend a simple breathing test called spirometry. This test assesses how much air your lungs can inhale and exhale and at what rate. Spirometry can detect COPD even before symptoms occur and give you a good indication of your lung function and how much damage they have endured. Other methods used to diagnose COPD include chest x-rays, CT scans and arterial blood gas analysis, which tests how well your lungs are bringing oxygen into your bloodstream and removing carbon dioxide.

The best way to prevent COPD is to quit smoking. By eliminating your exposure to tobacco smoke and other harmful chemicals found in cigarettes, you can significantly decrease your chances of developing the disease and other lung problems. Decreasing the amount of environmental pollutants you’re exposed to can also help prevent the onset of COPD.

Common treatment options for COPD include the following.

• Inhalers – Inhalers with bronchodilators, inhaled steroids or a combination of the two are common treatment options for COPD.
• Phophodiesterase-4 inhibitors – PDE4 inhibitors reduce swelling and relax the airways. The only PDE4 inhibitor currently approved to treat COPD is Daliresp.
• Antibiotics – Antibiotics can be used to treat conditions like acute bronchitis, pneumonia and influenza that can aggravate COPD symptoms.
• Oxygen therapy – Supplemental oxygen may be needed for those who don’t have enough oxygen in their blood. Portable oxygen tanks are the most common solution.
• Pulmonary rehabilitation – Pulmonary rehabilitation programs combine education, exercise training, nutrition advice and counseling. These programs can help you regain your ability to participate in daily activities.

INTEGRIS Pulmonology and Sleep Medicine offers top-notch care for every facet of respiratory disease, including COPD. For more information on offered services or to schedule an appointment, call 405-644-5040.