Author(s): Pea VS, Miravitlles M, Gabriel R, JimnezRuiz CA, Villasante C,
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Abstract OBJECTIVES: To ascertain the prevalence, diagnostic level, and treatment of COPD in Spain through a multicenter study comprising seven different geographic areas. DESIGN AND PARTICIPANTS: This is an epidemiologic, multicenter, population-based study conducted in seven areas of Spain. A total of 4,035 men and women (age range, 40 to 69 years) who were randomly selected from a target population of 236,412 subjects participated in the study. INTERVENTIONS: Eligible subjects answered the European Commission for Steel and Coal questionnaire. Spirometry was performed, followed by a bronchodilator test when bronchial obstruction was present. RESULTS: The prevalence of COPD was 9.1\% (95\% confidence interval [CI], 8.1 to 10.2\%), 15\% in smokers (95\% CI, 12.8 to 17.1\%), 12.8\% in ex-smokers (95\% CI, 10.7 to 14.8\%), and 4.1\% in nonsmokers (95\% CI, 3.3 to 5.1\%). The prevalence in men was 14.3\% (95\% CI, 12.8 to 15. 9\%) and 3.9\% in women (95\% CI, 3.1 to 4.8\%). Marked differences were observed between sexes in smoking; the percentage of nonsmokers was 23\% in men and 76.3\% in women (p<0.0001). The prevalence of COPD varied among the areas, ranging from 4.9\% (95\% CI, 3.2 to 7.0\%) in the area of the lowest prevalence to 18\% (95\% CI, 14.8 to 21.2\%) in the area of the highest. There was no previous diagnosis of COPD in 78.2\% of cases (284 of 363). Only 49.3\% of patients with severe COPD, 11.8\% of patients with moderate COPD, and 10\% of patients with mild COPD were receiving some kind of treatment for COPD. Multivariate analysis showed that individuals had a higher probability of having received a previous diagnosis of COPD if they lived in urban areas, were of male gender, were > 60 years old, had higher educational levels, had > 15 pack-year smoking history, or had symptoms of chronic bronchitis. CONCLUSIONS: COPD is a very frequent disease in Spain, and presents significant geographic variations and a very low level of previous diagnosis and treatment, even in the most advanced cases.
This article was published in Chest
and referenced in Journal of Nanomedicine & Nanotechnology