Investigació Aplicada en Malalties Respiratòries

Dr. Marc Miravitlles exposes the latest national epidemiologic results in a clinical session at the hospital Clinic of Barcelona

Chronic obstructive pulmonary disease (COPD) is a leading, but under-recognised, cause of morbidity and mortality worldwide. No other disease that is responsible for comparable burden worldwide is neglected by healthcare providers as much as COPD.

The available epidemiologic data in Spain has been recently reviewed elsewhere The Estudio epidemiológico de EPOC en España (IBERPOC) study, a landmark prevalence survey conducted in 1997, reported that 9.1% of the general Spanish population between 40 and 69 years of age had COPD.

In his latest study Dr. Miravitlles compared participants from the IBERPOC study (n=4,030), conducted in 1997, with those of the EPI-SCAN study (n=3,802) conducted in 2007. The results point out that COPD prevalence in the population between 40 to 69 years of age dropped from 9.1% (IC 95% 8.1-10.2) in 1997 to 4.5% (IC 95% 2.4-6.6), that is a 50, 4% decline. The distribution of COPD prevalence by severity also changed. Overall, underdiagnosis was reduced from 78% to 73% (p n.s.) and undertreatment from 81% to 54% (p < 0.05) within this ten-year frame, in Spain.

In conclusion, the finding of a substantial reduction in the prevalence of objectively defined post-bronchodilator airflow obstruction, compatible with COPD in Spain, is unexpected, as well as the observed changes in the severity distribution, and highlight the difficulties to compare repeated cross-sectional surveys of spirometry in the population.