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Original Research: COPD |

Family History Is a Risk Factor for COPDFamily History Is a Risk Factor for COPD

Craig P. Hersh, MD, MPH; John E. Hokanson, PhD, MPH; David A. Lynch, MB; George R. Washko, MD; Barry J. Make, MD; James D. Crapo, MD; Edwin K. Silverman, MD, PhD; the COPDGene Investigators
Author and Funding Information

From the Channing Laboratory (Drs Hersh and Silverman) and the Division of Pulmonary and Critical Care Medicine (Drs Hersh, Washko, and Silverman), Brigham and Women’s Hospital, Harvard Medical School, Boston, MA; Colorado School of Public Health (Dr Hokanson), University of Colorado, Aurora; and the Department of Radiology (Dr Lynch) and the Division of Pulmonary and Critical Care Medicine (Drs Make and Crapo), National Jewish Health, Denver, CO.

Correspondence to: Craig P. Hersh, MD, MPH, Channing Laboratory, Brigham and Women’s Hospital, 181 Longwood Ave, Boston, MA 02115; e-mail: craig.hersh@channing.harvard.edu


Funding/Support: This work was supported by the National Institutes of Health [Grants U01HL089856 (E. K. S.), U01HL089897 (J. D. C.), K08HL080242 (C. P. H.), R01HL094635 (C. P. H.)]; and a grant from the Alpha-1 Foundation (C. P. H.).

A complete list of the COPDGene Investigators can be found in e-Appendix 1.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (http://www.chestpubs.org/site/misc/reprints.xhtml).


© 2011 American College of Chest Physicians


Chest. 2011;140(2):343-350. doi:10.1378/chest.10-2761
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Background:  Studies have shown that family history is a risk factor for COPD, but have not accounted for family history of smoking. Therefore, we sought to identify the effects of family history of smoking and family history of COPD on COPD susceptibility.

Methods:  We compared 821 patients with COPD to 776 control smokers from the Genetic Epidemiology of COPD (COPDGene) Study. Questionnaires captured parental histories of smoking and COPD, as well as childhood environmental tobacco smoke (ETS) exposure. Socioeconomic status was defined by educational achievement.

Results:  Parental history of smoking (85.5% case patients, 82.9% control subjects) was more common than parental history of COPD (43.0% case patients, 30.8% control subjects). In a logistic regression model, parental history of COPD (OR, 1.73; P < .0001) and educational level (OR, 0.48 for some college vs no college; P < .0001) were significant predictors of COPD, but parental history of smoking and childhood ETS exposure were not significant. The population-attributable risk from COPD family history was 18.6%. Patients with COPD with a parental history had more severe disease, with lower lung function, worse quality of life, and more frequent exacerbations. There were nonsignificant trends for more severe emphysema and airway disease on quantitative chest CT scans.

Conclusions:  Family history of COPD is a strong risk factor for COPD, independent of family history of smoking, personal lifetime smoking, or childhood ETS exposure. Although further studies are required to identify genetic variants that influence COPD susceptibility, clinicians should question all smokers, especially those with known or suspected COPD, regarding COPD family history.

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