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Altitude and COPD prevalence: analysis of the PREPOCOL-PLATINO-BOLD-EPI-SCAN study.

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Title: Altitude and COPD prevalence: analysis of the PREPOCOL-PLATINO-BOLD-EPI-SCAN study.
Authors: Horner, A
Soriano, JB
Puhan, MA
Studnicka, M
Kaiser, B
Vanfleteren, LEGW
Gnatiuc, L
Burney, P
Miravitlles, M
García-Rio, F
Ancochea, J
Menezes, AM
Perez-Padilla, R
Montes de Oca, M
Torres-Duque, CA
Caballero, A
González-García, M
Buist, S
Flamm, M
Lamprecht, B
BOLD Collaborative Research Group
EPI-SCAN Team
PLATINO Team
PREPOCOL Study Group
Item Type: Journal Article
Abstract: BACKGROUND: COPD prevalence is highly variable and geographical altitude has been linked to it, yet with conflicting results. We aimed to investigate this association, considering well known risk factors. METHODS: A pooled analysis of individual data from the PREPOCOL-PLATINO-BOLD-EPI-SCAN studies was used to disentangle the population effect of geographical altitude on COPD prevalence. Post-bronchodilator FEV1/FVC below the lower limit of normal defined airflow limitation consistent with COPD. High altitude was defined as >1500 m above sea level. Undiagnosed COPD was considered when participants had airflow limitation but did not report a prior diagnosis of COPD. RESULTS: Among 30,874 participants aged 56.1 ± 11.3 years from 44 sites worldwide, 55.8% were women, 49.6% never-smokers, and 12.9% (3978 subjects) were residing above 1500 m. COPD prevalence was significantly lower in participants living at high altitude with a prevalence of 8.5% compared to 9.9%, respectively (p < 0.005). However, known risk factors were significantly less frequent at high altitude. Hence, in the adjusted multivariate analysis, altitude itself had no significant influence on COPD prevalence. Living at high altitude, however, was associated with a significantly increased risk of undiagnosed COPD. Furthermore, subjects with airflow limitation living at high altitude reported significantly less respiratory symptoms compared to subjects residing at lower altitude. CONCLUSION: Living at high altitude is not associated with a difference in COPD prevalence after accounting for individual risk factors. However, high altitude itself was associated with an increased risk of undiagnosed COPD.
Issue Date: 23-Aug-2017
Date of Acceptance: 13-Aug-2017
URI: http://hdl.handle.net/10044/1/50752
DOI: https://dx.doi.org/10.1186/s12931-017-0643-5
ISSN: 1465-9921
Publisher: BioMed Central
Journal / Book Title: Respiratory Research
Volume: 18
Issue: 1
Copyright Statement: © The Author(s). 2017 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
Sponsor/Funder: Wellcome Trust
Funder's Grant Number: 085790/Z/08/Z
Keywords: COPD
Epidemiology
Geographical altitude
Risk factors
Underdiagnosis
BOLD Collaborative Research Group
EPI-SCAN Team
PLATINO Team
PREPOCOL Study Group
1102 Cardiovascular Medicine And Haematology
1103 Clinical Sciences
Respiratory System
Publication Status: Published online
Article Number: 162
Appears in Collections:National Heart and Lung Institute