Study finds COPD-like respiratory symptoms common among smokers despite lack of COPD diagnosis

WHAT:  In a finding that could lead to better treatment of smoking-related lung diseases, scientists are reporting that about half of current or former smokers have respiratory symptoms similar to COPD and an increased risk for exacerbations or “flare ups” of their symptoms despite normal lung function and a lack of COPD diagnosis.  Many of these individuals show COPD-like symptoms, such as shortness of breath and difficulty exercising. They also have a high rate of respiratory medication use despite a lack of data from clinical trials about appropriate treatment of this particular patient population, the researchers note.   

In addition to raising the question of whether the definition of COPD should be adjusted, the researchers say that the study highlights a large, understudied patient population who might nevertheless benefit from early treatment intervention.  Their study, which appears online in the New England Journal of Medicine, is funded by both the National Heart, Lung, and Blood Institute (NHLBI) and the Foundation for the National Institutes of Health (FNIH).

COPD, or chronic obstructive pulmonary disease, is the third leading cause of death in the United States.  It is a progressive lung disease that makes it hard to breathe. Cigarette smoking is the leading cause of COPD.  While researchers estimate that millions of Americans have COPD, many have the disease and do not know it. The condition is currently diagnosed using spirometry, a test that measures how much air you breathe out and how fast. Researchers have long observed that some current and former smokers appear to have respiratory symptoms associated with COPD—such as coughing and shortness of breath—despite having a normal spirometry test.  However, the extent and clinical implications of this problem were unknown until now.

For the current study, a research team led by scientists at several institutions, including the University of California at San Francisco and the University of Michigan, conducted an observational study called SPIROMICS (Subpopulations and Intermediate Outcome Measures in COPD Study). It includes patient data collected between 2010 and 2015.  The scientists examined respiratory symptoms and measured lung function with spirometry among 2,736 current or former smokers (40 to 80 years of age) as well as controls who had never smoked.  They found that respiratory symptoms were present in about half of the current or former smokers despite normal spirometry readings. Participants who had respiratory symptoms despite normal spirometry had an increased rate of exacerbations or “flare ups” of their symptoms. Using computed tomographic (CT) imaging scans of the lung, the researchers also found a high incidence of thickening of the airways, a sign of lung disease.

WHO:  James Kiley, Ph.D., director of the Division of Lung Diseases at the NHLBI, is available to comment on the findings and implications of this research.

CONTACT:  For more information or to schedule an interview, please contact the NHLBI Office of Science Policy, Engagement, Education, and Communications at 301-496-5449 or nhlbi_news@nhlbi.nih.gov (link sends e-mail).