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Similarities and Differences in Asthma and COPD*: The Dutch Hypothesis

Eugene R. Bleecker, MD, FCCP
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*From the Center for Human Genomics, Wake Forest University, Winston-Salem, NC.

Correspondence to: Eugene R. Bleecker, MD, FCCP, Center for Human Genomics, Wake Forest University, Medical Center Blvd, Winston-Salem, NC 27157; e-mail: ebleeck@wfubmc.edu



Chest. 2004;126(2_suppl_1):93S-95S. doi:10.1378/chest.126.2_suppl_1.93S
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COPD represents an increasingly important chronic debilitating illness in the United States and worldwide.1 Approximately 16 million Americans have received a diagnosis of COPD, but this figure may represent a low estimate, since there is evidence of misclassification and underdiagnosis, with COPD remaining undiagnosed by a physician in as many as 30 million individuals. The National Health and Nutrition Examination Survey2 of 16,084 individuals who were > 17 years of age revealed that 25% of white male smokers had evidence of airway obstruction, as documented by an FEV1/FVC ratio of < 70%.3 Even more impressive was that COPD had not been previously diagnosed in 44% of those with an FEV1/FVC ratio of < 50% predicted. Mortality caused by COPD has increased, and this disease has become the fourth leading cause of death in the United States.5 COPD is the only disease among the top 10 causes of death that is increasing in frequency.67 It is anticipated that the prevalence of COPD will continue to increase through the year 2020 and beyond.

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