Recent trends in physician diagnosed COPD in women and men in the UK

Background-Recent trends in physician diagnosed chronic obstructive pulmona ry disease (COPD) in the UK were estimated, with a particular focus on wome n. Methods-A retrospective cohort of British patients with COPD was constructe d from the General Practice Research Database (GPRD), a large automated dat abase of UK general practice data. Prevalence and all-cause mortality rates by sex, calendar year, and severity of COPD, based on treatment only, were estimated from January 1990 to December 1997. Results-A total of 50 714 incident COPD patients were studied, 23 277 (45.9 %) of whom were women. Front 1990 to 1997 the annual prevalence rates of ph ysician diagnosed COPD in women rose continuously from 0.80% (95% CI 0.75 t o 0.83) to 1.36% (95% CI 1.34 to 1.39), (p for trend <0.01), rising to the rate observed in men in 1990. Increases in the prevalence of COPD were obse rved in women of all ages; in contrast, a plateau was observed in the preva lence of COPD in men from the mid 1990s. All-cause mortality rates were hig her in men than in women (106.8 versus 82.2 per 1000 person-years), with a consistently increased relative risk in men of 1.3 even after controlling f or the severity of COPD. Significantly increased mortality rates were also observed in adults aged less than 65 years. The mean age at death was 76.5 years; patients with severe COPD died an average of three years before thos e with mild disease (p<0.01) and four years before the age and sex matched reference population. Conclusions-While prevalence rates of COPD in the UK seem to have peaked in men, they are continuing to rise in women. This trend, together with the a geing of the population and the long term cumulative effect of pack-years o f smoking in women, is likely to increase the present burden of COPD in the UK.