What is COPD and its causes?

COPD mostly affects people with a long history of smoking and is characterized by coughing, spitting up, and shortness of breath. Although it is a chronic condition, good habits improve your prognosis.

A chronic obstructive pulmonary disease that primarily affects the respiratory system. It is characterized by a limitation to the passage of air into the lungs due to the organism’s inflammatory reaction to stimuli harmful as the smoke of the snuff or other gases. Due to its chronic nature, it is not reversible and manifests itself with exacerbations, in most cases secondary to infections. This problem has a high impact on the daily life of those who suffer from it since it limits mobility and the development of most daily activities.

It occurs mainly in people with a long history of smoking (it is estimated that 90% of COPD cases are a direct consequence of tobacco smoke). Its main symptoms are coughing and expectoration and difficulty breathing or dyspnoea. The use of solid fuels (firewood, charcoal) inside homes for cooking and heating the interior also increases the risk of suffering.

COPD mainly affects men, smokers, and ex-smokers, over 40 years of age. Although in developed countries, the prevalence is increasing in women and young people due to changes in smoking habits (one in three young people between 16 and 24 years old smokes). The Spanish Society of Pulmonology and Thoracic Surgery (SEPAR) estimates that 10% of the population between 40 and 80 years of age suffers from this disease; however, it is estimated that 81.7% are undiagnosed. In the age group over 65, the percentage of those affected is 20%.

Types of COPD

Several types of COPD have been classified to distinguish characteristics that are useful from a therapeutic point of view. Currently recognized:

• Bronchitis chronic: characterized by inflammation of the airways and increased mucus production response of the organism to noxious stimuli such as smoke snuff.

• To this type of COPD, it is necessary to add a new characteristic and therapeutic interest defined as an exacerbator or non-exacerbator. It refers to the number of decompensations of the disease in a year, the exacerbator being the one that presents two or more moderate-severe crises per year. These patients will reinforce anti-inflammatory treatment in their daily therapy.
• COPD-ASTHMA: this group includes those patients who combine the definition of COPD but whose decompensations are usually characterized by asthmatic attacks, and therefore, reversible with adequate treatment. From the point of view of diagnostic spirometry, they present an airflow obstruction but with some reversibility if a certain bronchodilator treatment is applied.

Causes of COPD

The main risk factor for developing COPD (90% of cases) is tobacco use, along with exposure to tobacco smoke.

The risk is higher in long-term smokers and affects cigarette users more than those who smoke rolling tobacco or pipes. So much so that the risk of suffering from COPD goes from 25% to more than 50% when more than 30 packs of cigarettes are consumed per year.

Passive exposure to smoke from the snuff also helps develop respiratory symptoms and COPD. Approximately 20% of patients with the disease have no previous history of smoking. In some scientific studies, it has been shown that the spirometry of children whose parents are smokers and, therefore, are passively exposed to smoke is significantly worse than that of those free from an environment with tobacco.

Other risk factors associated with the onset of COPD are:

• Occupational exposure to organic and inorganic dust, chemicals, and vapors.
• Environmental pollution inside homes (for example, from fuels used for cooking and heating in poorly ventilated environments).
• Air pollution.
• Previous history of respiratory infections. In particular, tuberculosis is directly related to COPD development.
• Genetic deficiency of a protein called alpha-1-antitrypsin (produces a disease that affects younger people). It is directly related to pulmonary emphysema and represents around 1-2% of cases.