Chronic obstructive pulmonary disease

Chronic obstructive pulmonary disease is a disease of the lungs, characterized by a chronic restriction of air flow in the respiratory tract. Symptoms worsen with time. Dyspnea during physical activity gradually turns into dyspnea at rest. This disease is often not diagnosed and can be dangerous to life. Previously, COPD was often called the terms “chronic bronchitis” and “emphysema”.

Risk factors

Chronic obstructive pulmonary disease

The main cause of COPD is tobacco smoke (including secondary smoke inhalation or secondhand smoke). Other risk factors include: indoor air pollution (e.g., through the use of solid fuels for cooking and heating); air pollution; dust and chemicals in the workplace (fumes, irritants and fumes); frequent infections of the lower respiratory tract in childhood.
In the past, men were more likely to be affected by COPD, but because in high-income countries the prevalence of smoking among women is as high as among men, and in low-income countries women are more likely to be affected by indoor air pollution (e.g., from solid fuels for cooking and heating), today men and women are almost equally affected.
More than 90 percent of deaths from COPD occur in low- and middle-income countries, where effective strategies to prevent and control the disease are not always implemented or available.


Chronic obstructive pulmonary disease develops slowly and is usually manifested in people older than 40-50 years. The most common symptoms of COPD are shortness of breath (“air shortage”), chronic cough and sputum separation. As the health condition worsens, the patient may have difficulty even doing the usual daily activities, such as climbing a small flight of stairs or carrying a suitcase. In addition, patients often have exacerbations, that is, serious episodes of severe shortness of breath, cough and sputum separation, which last from a few days to several weeks. These episodes can lead to a marked decrease in work capacity and the need for emergency medical care (including hospitalization), and sometimes death.

Diagnosis and Treatment

Chronic obstructive pulmonary disease

Usually, the suspicion of chronic obstructive pulmonary disease arises in people with the symptoms described above. The diagnosis can be confirmed by a breath test called spirometry, which measures how much air a person can exhale at a time with maximum force and how quickly.
Chronic obstructive pulmonary disease is incurable. However, available medications and physiotherapy can alleviate symptoms, increase the ability to bear the load and improve quality of life, as well as reduce the risk of death. The most effective and cost-effective treatment for COPD among smokers is smoking cessation.
The availability of opportunities to diagnose and treat COPD depends on the degree of resource availability. WHO has published guidelines with specific recommendations for COPD management in primary health care settings and resource-constrained settings.

WHO activity

WHO’s work on COPD is part of the organization’s overall efforts to prevent and control non-communicable diseases. The goals of WHO are: to raise awareness of the global epidemic of non-communicable diseases; create a healthier environment, especially for poor and disadvantaged populations;
reduce common risk factors for non-communicable diseases, such as tobacco use, poor nutrition and physical inactivity; preventing premature death and preventable disability due to major non-communicable diseases.
The WHO Framework Convention on Tobacco Control was developed in response to the globalization of the tobacco epidemic to protect billions of people from the harmful effects of tobacco. It is the first global health agreement concluded by WHO and ratified by more than 180 countries.

Chronic bronchitis

Chronic bronchitis is a chronic inflammation of bronchitis resulting from prolonged acute bronchitis (e.g. after measles or flu) or long-term exposure of the mucous membrane of bacteria to bronchitis (e.g. after the passage of measles or flu), Haemophilus influenzae, Streptococcus pneumoniae) or viruses (e.g. RS-virus, adenoviruses), physical and chemical factors (smoking, cooling the respiratory tract, dusting the air with industrial waste, etc.). etc.), so says Dr. Denis Slinkin.

It is now proven that chronic bronchitis develops in almost 100% of cases among smokers. Chronic inflammation may be accompanied by metaplasia of the epithelium, resulting in a decrease in the number of cells with eyelashes. With constant exposure to cigarette smoke may dysplasia epithelium, uthe development of malignant tumors.

In the clinic, exacerbations of the disease are combined with periods of remission. Most patients with chronic bronchitis develop pulmonary emphysema. Complications of chronic bronchitis are right ventricular failure and lung failure, so says Dr. Denis Slinkin.

Morphological changes

Dr. Denis Slinkin

Dr. Denis Slinkin will assert that in the early stages of the disease chronic bronchitis of infectious nature may initially have a local nature, there is inflammation of respiratory bronchitis with a diameter of less than 2 mm. Chronic inflammation may lead to destruction of the bronchial wall and surrounding elastin fibres, which leads to the development of centrolobular emphysema. Reduced air pressure and pliability of the bronchial walls, together with blockage of the lumen by slime, lead to significant difficulties in air passage through the airways. Chronic bronchitis and emphysema are usually observed simultaneously in different proportions.