Chronic Obstructive Pulmonary Disease COPD is defined as the presence of airflow obstruction due to chronic bronchitis or emphysema. It may include a reversible component and some patients with asthma may go on to develop irreversible airflow obstruction and be included in chronic obstructive pulmonary disease, emphysema, bronchitis, emfasema, empasema Chronic bronchitis is defined as chronic productive cough for three months in each of two successive years when other causes of chronic cough are excluded. That includes gastroesophageal reflux disease, asthma or something like that. Emphysema is defined as abnormal permanent enlargement of air spaces distal to the terminal bronchioles. This is an airways disease, this is an alveolar disease.
Smoking is the most common risk factor.
Passive smoking in a few patients, ambient air pollution has been implicated. We talked about hyperresponsive airways such as asthma. I wanted to discuss the relationship of smoking, FEV-1 or lung function and age. This graph essentially summarizes that relationship. What they looked at is smoking intervention versus ipratropium four times a day.