NIH News Release
National Heart, Lung, and Blood Institute

Wednesday, April 4, 2001
NHLBI Communications Office
(301) 496-4236

International Guidelines Released on Chronic Obstructive Lung Disease (COPD)
Fourth Leading Cause of Death in US and Worldwide

The first international guidelines for the diagnosis, management, and prevention of Chronic Obstructive Lung Disease (COPD) — currently the fourth leading cause of death in the US and worldwide — were released today by an international team of scientists from the Global Initiative for Chronic Obstructive Lung Disease (GOLD). The GOLD Workshop Report, which provides evidence-based recommendations for the clinical management of COPD, is the first step in an international effort to boost awareness of COPD and improve the way it is treated. GOLD was created by the National Heart, Lung, and Blood Institute (NHLBI) at the National Institutes of Health and the World Health Organization.

According to NHLBI Director Dr. Claude Lenfant, "COPD has become a major public health problem worldwide. That's why we, with the WHO, initiated this program. We hope that this report will increase worldwide awareness of COPD and help the millions of people who suffer from this disease."

COPD, a term used to describe chronic bronchitis and emphysema, is a slowly progressive airways disease characterized by a gradual loss of lung function. In the US, it is caused primarily by cigarette smoking. There is no known cure, but smoking cessation can slow disease progression.

COPD has been on the increase in the US, and in 1996, an estimated 16 million Americans had COPD. The number of deaths attributed to COPD has also increased substantially in the past 40 years to approximately 100,000 men and women per year in the US alone. The highest rate of increase in deaths has been seen in white women.

It is expected that by 2020, COPD will rank as the third leading cause of death, surpassing stroke. The annual cost of COPD to the US economy is estimated at nearly $30.4 billion.

The GOLD Report, which was reviewed extensively by medical societies in more than 100 countries throughout both the developed and developing world, emphasizes the need for clinicians and patients to recognize cough and sputum production as early signs of possible COPD and calls for the use of spirometry, a simple test of lung function, to confirm the diagnosis. It also provides a general scheme for classifying COPD by severity to help clinicians determine how best to manage the condition. Practical recommendations for reducing risk factors and for managing both stable COPD and exacerbations are also provided.

Said Lenfant, "A concerted effort by government officials, health care workers, biomedical researchers, industry, and patients throughout the world is required to improve the way COPD is diagnosed and managed and to increase research into improved treatments and ultimately a cure. This effort has begun with the launch of the GOLD Initiative today."

For further information, contact the NHLBI Communications Office at 301-496-4236.

Copies of the GOLD Workshop Report and other information on COPD are available on the NHLBI Web Site at