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OVERALL KEY POINTS - COPD has an insidious onset in the susceptible smoker. - The 'Holy Grail' is early detection with spirometry and smoking cessation. - Severity assessment should include exacerbations, dyspnoea scale and BMI. - Assessment for oxygen therapy is essential in COPD with signs of hypoxia.
COPD is characterised by airflow obstruction that is usually progressive, not fully reversible and does not change markedly over several months.
The airflow obstruction is a combination of airway and parenchymal damage and the inflammatory component differs from that seen in asthma.
The particularly worrying aspect of this disease is its insidious onset with significant airflow obstruction occurring before the individual is aware of it. The susceptible smoker with more rapid lung function decline will live longer and significantly defer disability by quitting, and so the 'Holy Grail' in COPD management is early detection and successful smoking cessation.
Although COPD is predominantly caused by smoking, some older patients may have suffered from poor socio-economic backgrounds, domestic and environmental pollution and bad working environments. Sadly, the number of 12-year-olds who smoke regularly has increased from 8 per cent in 1988 to around …