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Chronic bronchitis and emphysema are forms of COPD.
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Chronic bronchitis and emphysema are lung disorders are included in a larger disease category called chronic obstructive pulmonary disease, or COPD. These conditions share overlapping causes and symptoms, and often occur together. Chronic bronchitis causes a persistent cough that produces a lot of phlegm. Emphysema is characterized by destruction of lung tissue that leads to severe shortness of breath and overexpansion of your lungs. In terms of death and disability, COPD inflicts significant burdens on individuals, families and society.
Slow, Progressive Course
People with COPD typically develop a persistent, productive cough -- chronic bronchitis -- during their 40s or 50s after years of exposure to substances that are toxic to lung tissue. Chronic bronchitis may herald the onset of a gradual deterioration in lung function that eventually leads to emphysema and severe disability.
The slow progression of COPD is typically interrupted by periodic flare-ups, or exacerbations, when your symptoms suddenly grow markedly worse. Exacerbations significantly increase your short-term risk of dying, or mortality. These flare-ups also typically cause you to profoundly feel ill and diminish your ability to maintain your usual activities. Medical professionals refer to the burden of illness within a population as morbidity.
Because emphysema represents a more severe form of COPD and is associated with greater lung damage, morbidity and mortality are higher for emphysema than for chronic bronchitis.
In the context of public health, morbidity refers to the frequency with which a disease occurs in addition to impact of the disease. The Centers for Disease Control and Prevention reports that at least 10 million Americans have chronic bronchitis, and nearly 5 million suffer from emphysema. More than 300,000 annual emergency room visits are attributed to chronic bronchitis alone. Two-thirds of COPD patients have disabling shortness of breath, and nearly 25 percent suffer from severe pain.
CDC reports that chronic bronchitis accounted for 620 U.S. deaths in 2010. More than 10,000 deaths were attributed to emphysema during the same year. The Global Initiative for Chronic Obstructive Lung Disease observed that mortality due to COPD increases with age. This is not surprising because COPD tends to worsen with advancing age. In addition, older people often have other medical conditions that, when combined with COPD, increase mortality risk.
Age is only one factor that contributes to mortality in people with COPD. A study published in 2012 in the journal "Thorax" revealed an increase in mortality after every COPD exacerbation. These flare-ups are more frequent and severe among people who continue to smoke.
COPD is the third leading cause of death in the U.S. However, there has been a recent decrease in the death rate due to COPD, according to a 2012 report in the "International Journal of Chronic Obstructive Pulmonary Disease." This trend probably reflects improved treatment of both COPD flare-ups and stable disease.
Other trends worth noting are an apparent decline in the death rate among men with COPD, while mortality seems to be stable or increasing in women. The causes of such trends are not entirely clear. Smoking remains the primary cause of COPD worldwide.