In chronic obstructive pulmonary disease – colloquially called COPD – (synonyms: Airway obstruction; chronic obstructive airway disease (COAD); chronic obstructive lung disease (COLD); chronic obstructive pulmonary disease (COPD); chronic obstructive airway disease; Chronic obstructive pulmonary disease (COPE); Chronic obstructive bronchitis; Chronic obstructive pulmonary disease; Chronic obstructive pulmonary disease; Obstructive lung; Obstructive lung disease; ICD-10-GM J44. 9-: Chronic obstructive pulmonary disease, unspecified) there is progressive (progressive), not fully reversible (reversible) obstruction (narrowing) of the airways. Chronic obstructive pulmonary disease (COPD) is not a disease in its own right, but is a clinical picture of chronic obstructive bronchitis and emphysema (pulmonary hyperinflation) defined functionally by airway obstruction. However, bronchial asthma is not included in the definition of chronic obstructive pulmonary disease (COPD). ACOS (asthma-COPD overlap syndrome) is present when typical signs of both diseases are clearly present, for example, asthma has been known to exist since childhood. Chronic obstructive pulmonary disease (COPD) is one of the most common chronic diseases. According to the World Health Organization (WHO), chronic obstructive pulmonary disease (COPD) is the fourth leading cause of death worldwide. Sex ratio: males to females is 2: 1, with an increasing proportion of females. Peak incidence: the peak incidence of chronic obstructive pulmonary disease (COPD) is between the ages of 40 and 55. The prevalence (disease incidence) is about 13.2% in Germany. In the group of people older than 40 years, the prevalence is 13 %. In Europe and North America, approximately 8-13% of adults have chronic obstructive pulmonary disease (COPD). Course and prognosis: Chronic obstructive pulmonary disease (COPD) leads to a significant reduction in the performance of the affected person, which is already noticeable in everyday stress such as climbing stairs. Shortness of breath initially occurs only during physical exertion and in advanced stages, but also at rest. Typical in the further course of the disease is an increasing drop in performance with rapid weight loss (so-called “COPD-wasting”) – within a few weeks the weight can drop by several kilograms! The disease is characterized by exacerbations (“disease episodes”), which occur on average about once a year. Patients with at least moderate obstruction remain free of exacerbations for 3 years in only 23% of cases.Exacerbations are defined as acute worsening of respiratory symptoms with cough, sputum (sputum), and dyspnea (shortness of breath) lasting for at least two days. Even asymptomatic COPD, i.e., previously unrecognized COPD, already increases morbidity (disease incidence) and mortality (morbidity). In light of this, spiroergometry screening for long-time smokers should be considered. A cure for the disease is not possible, but with adequate therapy, symptoms can be alleviated and progression (“progression”) of chronic obstructive pulmonary disease (COPD) slowed. Comorbidities (Concomitant Diseases): Chronic obstructive pulmonary disease is increasingly associated with hypertension (high blood pressure), coronary artery disease (CAD; coronary artery disease), peripheral arterial disease (CAD; progressive narrowing of the arteries supplying the arms/(more frequently) legs, usually due to atherosclerosis (hardening of the arteries)), pulmonary hypertension (PH; pulmonary hypertension), heart failure (cardiac insufficiency) and atrial fibrillation (VHF). Another comorbidity is diabetes mellitus type 2 (prevalence (disease incidence): 10-20%).Cluster analysis revealed five phenotypes of comorbidities: 1. cardiovascular, 2. few comorbidities, 3. metabolic syndrome, sleep apnea, anxiety/depression, 4. malnutrition, osteoporosis, 5. bronchiectasis. The clusters were mostly significantly associated with symptomatic patients, i.e., GOLD B and GOLD D.Under exacerbations, the occurrence of a cardiovascular event, such as myocardial infarction or pulmonary artery embolism, is more likely.Note: According to GOLD, one in six COPD patients with advanced stage III or IV disease has concomitant obstructive sleep apnea syndrome (OSA; pauses in breathing during sleep caused by airway obstruction) (overlap syndrome); this is associated with increased morbidity (morbidity) and mortality (mortality).
