Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #112395

Carlos A. Camargo, MD, DrPH¹, R. Graham Barr, MD, DrPH², Kourtney J. Davis, PhD, MSPH³, Rong Chen, MS⁴, and Frank Erwin Speizer, MD⁴. (1) Department of Medicine-Brigham & Women's Hospital, Harvard Medical School, 181 Longwood Ave, Boston, MA 02115, (617) 726-5276, ccamargo@partners.org, (2) Division of General Medicine, Columbia-Presbyterian Medical Center, PH-9 East Room 105, 622 West 168th St, New York, NY 10032, (3) Worldwide Epidemiology, GlaxoSmithKline, 5 Moore Drive, PO Box 13398, Research Triangle Park, NC 27709-3398, (4) Department of Medicine-Brigham and Women's Hospital, Harvard University, 181 Longwood Ave., Boston, MA 02115

Rationale: Asthma and chronic obstructive pulmonary disease (COPD) have clinical similarities. Together, they are the 4th most common cause of death. The actual mortality experience of these patients remains unclear. Methods: In 1976, the Nurses' Health Study enrolled 121,700 female registered nurses, ages 30-55 years. In 1986, the Health Professionals' Follow-up Study enrolled 51,529 male health professionals, ages 40-75 years. In both cohorts, participants were asked about physician-diagnosed asthma or COPD on biennial questionnaires. In 1998, participants were sent supplementary questionnaires about their asthma or COPD. Cases were matched to age- and sex-matched controls. Mortality was assessed through 2002. Results: Among 9426 women who responded to the supplement (>80% response, mean age 65), disease status was 5711 (61%) asthma only, 2209 (23%) asthma/COPD, and 1506 (16%) COPD only. Death occurred in 3%, 9%, and 16%, respectively. Among 2710 men who responded to the supplement (>80% response, mean age 66), 1,945 (72%) had asthma only, 290 (11%) asthma/COPD, and 475 (18%) COPD only. Death occurred in 6%, 16%, and 24%, respectively. Survival curves were consistent between cohorts. Compared to matched controls, subjects with “asthma only” had no significant increase in mortality, whereas subjects with asthma/COPD (p<0.01) and COPD only (p<0.001) were at higher risk. Asthma/COPD had a lower mortality rate than COPD only (p<0.01). Conclusion: Participants with asthma alone had no increase in mortality rates compared to controls, whereas those with COPD had much higher mortality rates. This mortality pattern was very similar between men and women with obstructive airway disease.

Learning Objectives:

• Describe the mortality experience of men and women with asthma.
• Describe mortality experience of men and women with chronic obstructive pulmonary disease (COPD).
• Articulate the importance of public health efforts to control COPD.

Keywords: Asthma, Tobacco

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.