Chest
Original ResearchThirty-Year Cumulative Incidence of Chronic Bronchitis and COPD in Relation to 30-Year Pulmonary Function and 40-Year Mortality: A Follow-up in Middle-Aged Rural Men
Section snippets
Subjects
In 1959, all men (n = 1,711) aged 40 to 59 years from two rural areas in Finland were invited to the international Seven Countries Study17, 18 (Fig 1). Re-examinations were performed in 1964, 1969, 1974, 1984, 1989, and 2000.
Definition of Chronic Bronchitis
At the baseline, chronic bronchitis was defined as productive cough for at least 3 months a year.19 From 1969 to 1989, chronic bronchitis was defined by a positive response to the question, “Do you bring up phlegm on most days for as much as three months each year” (British
Results
By 75 years of age, the cumulative incidence of chronic bronchitis was 42% (95% confidence interval, 38 to 47%) in continuous smokers, compared to 26% (95% confidence interval, 18 to 34%) in ex-smokers and 22% (95% confidence interval, 16 to 28%) in never-smokers (Fig 2). The cumulative incidence of chronic bronchitis leveled off after the age of 65 years. The cumulative incidence of persistent chronic bronchitis was 22% (95% confidence interval, 19 to 26%) in continuous smokers, compared to
Discussion
In our study, > 40% of smokers living in a rural environment acquired chronic bronchitis during their life; in most cases, chronic bronchitis was persistent and half of those subjects with chronic bronchitis also acquired chronic airflow obstruction (COPD). In ex-smokers and never-smokers, chronic bronchitis was mostly nonpersistent, and most of subjects with airflow obstruction did not have chronic bronchitis. Generally, chronic bronchitis was associated with lower pulmonary function and
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Supported by the Finnish Academy, the Finnish Anti-Tuberculosis Association Foundation, the Finnish Lung Health Association, and the National Institute on Aging (United States) [grant EDC-1 1 RO1 AGO8762–01A1].
No author has any conflict of interest.
Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (www.chestjournal.org/misc/reprints.shtml).