A DPOC é a terceira principal causa de morte em todo o mundo, causando 3.23 milhões de mortes em 2019, com 90% das mortes nos países de baixo e média rendas.[1]Global Initiative for Chronic Obstructive Lung Disease (GOLD). Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease: 2024 report. 2024 [internet publication].
https://goldcopd.org/2024-gold-report
[8]Halpin DMG, Celli BR, Criner GJ, et al. The GOLD Summit on chronic obstructive pulmonary disease in low- and middle-income countries. Int J Tuberc Lung Dis. 2019 Nov 1;23(11):1131-41.
https://www.ingentaconnect.com/content/iuatld/ijtld/2019/00000023/00000011/art00003;jsessionid=c66ehseg6kr89.x-ic-live-02
http://www.ncbi.nlm.nih.gov/pubmed/31718748?tool=bestpractice.com
[9]Meghji J, Mortimer K, Agusti A, et al. Improving lung health in low-income and middle-income countries: from challenges to solutions. Lancet. 2021 Mar 6;397(10277):928-40.
http://www.ncbi.nlm.nih.gov/pubmed/33631128?tool=bestpractice.com
[10]Adeloye D, Song P, Zhu Y, et al. Global, regional, and national prevalence of, and risk factors for, chronic obstructive pulmonary disease (COPD) in 2019: a systematic review and modelling analysis. Lancet Respir Med. 2022 May;10(5):447-58.
https://www.thelancet.com/journals/lanres/article/PIIS2213-2600(21)00511-7/fulltext
http://www.ncbi.nlm.nih.gov/pubmed/35279265?tool=bestpractice.com
[11]Safiri S, Carson-Chahhoud K, Noori M, et al. Burden of chronic obstructive pulmonary disease and its attributable risk factors in 204 countries and territories, 1990-2019: results from the Global Burden of Disease Study 2019. BMJ. 2022 Jul 27;378:e069679.
https://www.bmj.com/content/378/bmj-2021-069679
http://www.ncbi.nlm.nih.gov/pubmed/35896191?tool=bestpractice.com
Mundialmente, as mortes por DPOC aumentaram 23% entre 1990 e 2017 e estima-se que a DPOC e as mortes relacionadas aumentem para 5.4 milhões até 2060.[1]Global Initiative for Chronic Obstructive Lung Disease (GOLD). Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease: 2024 report. 2024 [internet publication].
https://goldcopd.org/2024-gold-report
[12]Li X, Cao X, Guo M, et al. Trends and risk factors of mortality and disability adjusted life years for chronic respiratory diseases from 1990 to 2017: systematic analysis for the Global Burden of Disease Study 2017. BMJ. 2020 Feb 19;368:m234. [Erratum in: BMJ. 2020 Aug 6;370:m3150.]
https://www.bmj.com/content/368/bmj.m234
http://www.ncbi.nlm.nih.gov/pubmed/32075787?tool=bestpractice.com
A DPOC é mais comum nos idosos, especialmente aqueles com 65 anos ou mais, independentemente de urbanização.[1]Global Initiative for Chronic Obstructive Lung Disease (GOLD). Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease: 2024 report. 2024 [internet publication].
https://goldcopd.org/2024-gold-report
A prevalência de DPOC é maior na região das Américas e menor nas regiões do Sudeste Asiático e do Pacífico Ocidental da Organização Mundial da Saúde. A prevalência global combinada é de 15.7% em homens e 9.93% em mulheres.[13]Varmaghani M, Dehghani M, Heidari E, et al. Global prevalence of chronic obstructive pulmonary disease: systematic review and meta-analysis. East Mediterr Health J. 2019 Mar 19;25(1):47-57.
https://www.emro.who.int/emhj-volume-25-2019/volume-25-issue-1/global-prevalence-of-chronic-obstructive-pulmonary-disease-systematic-review-and-meta-analysis.html
http://www.ncbi.nlm.nih.gov/pubmed/30919925?tool=bestpractice.com
A prevalência da DPOC nos EUA foi estimada em 14% dos resultados de testes pós-broncodilatador com base em dados de 2007 a 2010.[14]Tilert T, Dillon C, Paulose-Ram R, et al. Estimating the U.S. prevalence of chronic obstructive pulmonary disease using pre- and post-bronchodilator spirometry: the National Health and Nutrition Examination Survey (NHANES) 2007-2010. Respir Res. 2013 Oct 9;14(1):103.
https://respiratory-research.biomedcentral.com/articles/10.1186/1465-9921-14-103
http://www.ncbi.nlm.nih.gov/pubmed/24107140?tool=bestpractice.com
A taxa de mortalidade decorrente de DPOC nos EUA aumentou mais de 100% entre 1969 e 2013.[15]Ma J, Ward EM, Siegel RL, et al. Temporal trends in mortality in the United States, 1969-2013. JAMA. 2015 Oct 27;314(16):1731-9.
https://jamanetwork.com/journals/jama/fullarticle/2466136
http://www.ncbi.nlm.nih.gov/pubmed/26505597?tool=bestpractice.com
A National Health Interview Survey de 2019 revelou que a prevalência da DPOC em adultos nos EUA foi maior naqueles que moravam em áreas não metropolitanas que naqueles que moravam em áreas metropolitanas, sendo de 8.0% e 4.0%, respectivamente.[16]QuickStats: percentage of adults aged ≥18 years with diagnosed chronic obstructive pulmonary disease, by urbanization level and age group - National Health Interview Survey, United States, 2019. MMWR Morb Mortal Wkly Rep. 2021 Jul 2;70(26):959.
https://www.cdc.gov/mmwr/volumes/70/wr/mm7026a3.htm
http://www.ncbi.nlm.nih.gov/pubmed/34197360?tool=bestpractice.com
Antes, a maioria dos estudos relatava que a prevalência e a mortalidade por DPOC eram maiores nos homens que nas mulheres.[12]Li X, Cao X, Guo M, et al. Trends and risk factors of mortality and disability adjusted life years for chronic respiratory diseases from 1990 to 2017: systematic analysis for the Global Burden of Disease Study 2017. BMJ. 2020 Feb 19;368:m234. [Erratum in: BMJ. 2020 Aug 6;370:m3150.]
https://www.bmj.com/content/368/bmj.m234
http://www.ncbi.nlm.nih.gov/pubmed/32075787?tool=bestpractice.com
Entretanto, dados de 2012 a 2013 de países desenvolvidos sugerem que a prevalência de DPOC agora é quase igual entre homens e mulheres, provavelmente devido a padrões diferentes de tabagismo.[17]Landis SH, Muellerova H, Mannino DM, et al. Continuing to Confront COPD International Patient Survey: methods, COPD prevalence, and disease burden in 2012-2013. Int J Chron Obstruct Pulmon Dis. 2014 Jun 6;9(1):597-611.
https://www.dovepress.com/continuing-to-confront-copd-international-patient-survey-methods-copd--peer-reviewed-fulltext-article-COPD
http://www.ncbi.nlm.nih.gov/pubmed/24944511?tool=bestpractice.com
Alguns estudos também sugeriram que as mulheres podem apresentar maior risco de obstrução do fluxo aéreo que os homens, apesar da exposição a uma dose similar de tabaco.[18]Han MK. Chronic obstructive pulmonary disease in women: a biologically focused review with a systematic search strategy. Int J Chron Obstruct Pulmon Dis. 2020 Apr 1;15:711-21. [Erratum in: Int J Chron Obstruct Pulmon Dis. 2021 Nov 4;16:3017-8.]
https://www.dovepress.com/chronic-obstructive-pulmonary-disease-in-women-a-biologically-focused--peer-reviewed-fulltext-article-COPD
http://www.ncbi.nlm.nih.gov/pubmed/32280209?tool=bestpractice.com
Um estudo internacional relatou que a prevalência de DPOC entre indivíduos que nunca fumaram é de 12.2%.[19]Lamprecht B, McBurnie MA, Vollmer WM, et al; BOLD Collaborative Research Group. COPD in never smokers: results from the population-based Burden of Obstructive Lung Disease study. Chest. 2011 Apr;139(4):752-63.
https://journal.chestnet.org/article/S0012-3692(11)60174-8/fulltext
http://www.ncbi.nlm.nih.gov/pubmed/20884729?tool=bestpractice.com
Isso pode ocorrer devido à poluição do ar ou à queima de combustíveis sólidos em ambientes fechados nos países de baixa ou média rendas. Nos EUA, a prevalência de DPOC em indivíduos que nunca fumaram é de 2.2%. Muitos desses casos se devem à exposição em locais de trabalho, como no setor de mineração e no preparo e distribuição de alimentos.[20]Syamlal G, Doney B, Mazurek JM. Chronic obstructive pulmonary disease prevalence among adults who have never smoked, by industry and occupation - United States, 2013-2017. MMWR Morb Mortal Wkly Rep. 2019 Apr 5;68(13):303-7.
https://www.cdc.gov/mmwr/volumes/68/wr/mm6813a2.htm
http://www.ncbi.nlm.nih.gov/pubmed/30946736?tool=bestpractice.com
[21]Syamlal G, Kurth LM, Dodd KE, et al. Chronic obstructive pulmonary disease mortality by industry and occupation: United States, 2020. MMWR Morb Mortal Wkly Rep. 2022 Dec 9;71(49):1550-4.
https://www.cdc.gov/mmwr/volumes/71/wr/mm7149a3.htm
http://www.ncbi.nlm.nih.gov/pubmed/36480469?tool=bestpractice.com