Page 15 - Delaware Medical Journal - September 2017

SCIENTIFIC ARTICLE
INTRODUCTION
Asthma and Chronic Obstructive Pulmonary Disease (COPD) are recognized in public health as different diseases with unique clinical and epidemiological characteristics. Asthma is an allergic disease that
develops often during childhood, although it can also be diagnosed in adult life,
and is characterized by airway hyper- responsiveness that leads to episodic and usually reversible airway obstruction.
On the other hand, COPD is a chronic respiratory disease typically linked to smoking tobacco, presents most often in subjects older than 40 years of age, and is characterized by progressive and irreversible airway obstruction.1,2,3 These characteristics permit recognition of asthma and COPD as two distinct diseases.1 However, recently
in the 2015 Global Initiative for Chronic Obstructive Pulmonary Disease, an asthma- COPD overlap syndrome (ACOS) was recognized as a distinct clinical entity.4 ACOS is a syndrome in which older adults with an established smoking history have features of asthma in addition to their COPD. Previous research has suggested ACOS
is associated with worse health outcomes than either condition alone.5,6,7 ACOS patients have more concomitant wheezing, dyspnea and cough, and sputum production. Furthermore, ACOS patients seem to have not only more frequent, but also more severe exacerbations. The epidemiology of the condition is poorly described so far.1,6 To the best of our knowledge, no state-level data on the prevalence of ACOS has been reported. To assess the state-level prevalence of ACOS among adults, we analyzed data from the 2015 Behavioral Risk Factor Surveillance System (BRFSS). COPD and current asthma prevalence data were also presented for a quick comparison with ACOS.
The main objective of this study was to use data from 2015 BRFSS to examine the prevalence of asthma-chronic obstructive pulmonary disease
TABLE 1. Prevalence of Chronic Obstructive Pulmonary Disease (COPD), current Asthma and Asthma/COPD overlap syndrome (ACOS) among adults aged ≥18 years, by select characteristics — Behavioral Risk Factor Surveillance System, United States, 2015
COPD
% (95%CI)
Current Asthma % (95%CI)
6.2 (6.1- 6.4)
8.8 (8.6-8.9)
All Sex
Male
Female
Race
White NH
Black NH
Hispanic Other/multiracial NH
Age
18-24
25-44
45-64
65 and above
Education
Less than college
College graduate
Annual Household Income
Less than $25,000 $25,000-$50,000 More than $50,000
Insurance
Yes
No
Obesity
Obese Overweight Normal Underweight
Smoking
Current Former Never
Disability
Yes No
ACOS
% (95%CI)
2.2 (2.1-2.3)
1.5 (1.5-1.6) 2.8 (2.7-2.9)
2.5 (2.4-2.6) 2.3 (2.1-2.5) 1.1 (0.9-1.3) 1.8 (1.6-2.1)
0.7 (0.5-0.9) 1.1 (1.0-1.2) 3.0 (2.9-3.2) 3.6 (3.4-3.8)
2.6 (2.5-2.7) 0.9 (0.8-1.0)
4.3 (4.1-4.5) 1.9 (1.8-2.1) 1.0 (0.9-1.1)
2.3 (2.2-2.4) 1.5 (1.4-1.7)
3.5 (3.4-3.7) 1.8 (1.7-1.9) 1.5 (1.4-1.6) 3.2 (2.5-3.9)
4.7 (4.4-5.0) 3.4 (3.2-3.5) 1.0 (1.0-1.1)
7.0 (6.7-7.2) 0.9 (0.8-0.9)
5.5 (5.3-5.7)
6.2 (6.0-6.4)
7.0 (6.8-7.1)
11.2 (11.0-11.5)
7.4 (7.3-7.6)
8.9 (8.7-9.1)
5.8 (5.4-6.2)
10.6 (10.0-11.2)
2.9 (2.7-3.2)
7.2 (6.7-7.7)
4.4 (3.9-4.8)
8.4 (7.8-9.1)
2.1 (1.8-2.4)
10.2 (9.6-10.8)
2.7 (2.6-2.9)
8.3 (8.0-8.6)
7.7 (7.5-8.0)
9.0 (8.8-9.3)
12.3 (12.0-12.7)
8.2 (7.9-8.5)
7.5 (7.3-7.6)
9.3 (9.1-9.5)
2.8 (2.6-2.9)
7.2 (7.0-7.4)
10.9 (10.6-11.2)
11.9 (11.5-12.3)
6.4 (6.2-6.7)
8.2 (7.9-8.6)
3.2 (3.1-3.4)
7.2 (7.0-7.5)
6.5 (6.3-6.6)
9.1 (8.9-9.2)
4.7 (4.3-5.1)
6.8(6.3-7.3)
8.7 (8.4-9.0)
12.4 (12.1-12.8)
5.5 (5.3-5.7)
7.5 (7.3-7.8)
5.3 (5.0-5.5)
7.1 (6.9-7.4)
10.9 (9.7- 12.1)
8.6 (7.2-9.9)
13.9 (13.5-14.4)
11.3 (10.9-11.8)
10.0 (9.7- 10.3)
9.1 (8.8-9.4)
2.6 (2.5-2.7)
8.1 (7.9-8.3)
17.3 (16.9-17.7)
16.7 (16.3-17.1)
3.2 (3.1-3.3)
6.5 (6.4-6.7)
Del Med J | September 2017 | Vol. 89 | No. 9
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