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COPD: Guidelines Update and Newer Therapies
•The Problem•Pathogenesis•Key Clinical Concepts
 – Life Prolonging vs. Symptomatic Therapy – Spirometry - The Sixth Vital Sign – Use of clinical practice guidelines
•COPD Exacerbations• New Horizons
Outline
 
Percent Change in Age-Adjusted DeathRates, U.S., 1965-1998Percent Change in Age-Adjusted DeathRates, U.S., 1965-1998
000.50.51.01.01.51.52.02.02.52.53.03.0Proportion of 1965 RateProportion of 1965 Rate
1965 - 981965 - 98 –59% –59% –64% –64% –35% –35%
+163%+163%
 –7% –7%
CoronaryHeartDiseaseCoronaryHeartDiseaseStrokeStrokeOther CVDOther CVDCOPDCOPDAll Other CausesAll Other Causes
 
COPD in the United States
 Age-Adjusted Death Rates* for COPD by State: 1995-1997 
Deaths/100,000 PopHighest 46-61 (11) High 41-45 (13)Low 36-40 (13)Lowest 19-35 (13)*Morbidity and Mortality: 2000 Chart Book on Cardiovascular, Lung, andBlood Diseases. May 2000.
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