Treatment of mild chronic obstructive pulmonary disease

Figures & data

Figure 1 COPD Severity Classification Scheme Copyright © 2007. Reproduced with permission from O’Donnell DE, Aaron S, Bourbeau J, et al 2007. Canadian Thoracic Society recommendations for management of chronic obstructive pulmonary disease – 2007 update. Can Respir J, 14(Suppl B):5B–32B.

Figure 2 The relationship between forced expiratory volume in one second (FEV₁) and cardiovascular mortality or hospitalization in the First National Health Nutrition and Examination Survey (derived from Sin et al 2005b).

The Y-axis plots the relative risk of cardiovascular disease (CVD) hospitalization or mortality in subjects who participated in the NHANES 1 study. The x-axis plots the group in quintiles of FEV₁ and the mean FEV₁ value is shown for each of the quintile.

Figure 3 The effect of smoking cessation on cardiovascular and lung cancer mortality (derived from Anthonisen et al 2005).

The Y-axis plots the relative risk reduction in mortality from each of the causes relative continued smokers. Sustained quitters are defined as those who stopped smoking entirely during the follow-up period. Intermittent quitters are those who quit and re-started smoking.

Table 1 Management algorithm for mild COPD

	Asymptomatic	Intermittent symptoms	Persistent symptoms	Refractory symptoms
Smoking cessation	X	X	X	X
Short-acting bronchodilators		Xa	Xb	X
Long-acting bronchodilators			Xc	X
Inhaled glucocorticoids				Xd

a use on an as-needed basis.

b use on a regular basis (eg, 4 times a day).

c use in cases where patients remain symptomatic despite regular use of short acting bronchodilators.

d inhaled glucocorticoids may be added if patients remain symptomatic despite the regular use of long-acting bronchodilators. Inhaled glucocorticoids probably should not be used in by themselves.

O’DonnellDEAaronSBourbeauJ2007Canadian Thoracic Society recommendations for management of chronic obstructive pulmonary disease – 2007 updateCan Respir J14Suppl B5B32B

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SinDDWuLManSF2005bThe relationship between reduced lung function and cardiovascular mortality: a population-based study and a systematic review of the literatureChest1271952915947307

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AnthonisenNRSkeansMAWiseRA2005The effects of a smoking cessation intervention on 14.5-year mortality: a randomized clinical trialAnn Intern Med142233915710956

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