November 21, 2023
Chronic obstructive pulmonary disease (COPD) remains a little-known pathology. And yet it affects between 5 and 10% of adults over 45, represents a real burden on patients’ quality of life and causes around 18,000 deaths each year in France. As World COPD Day takes place this November 21, let’s lift the veil on this disease, its risk factors, its signs and its management.
Tobacco, an essential risk factor, but not the only one
« In Western countries, approximately 80% of COPD cases are attributable to tobacco. », explains Dr Frédéric Le Guillou, pulmonologist and allergist at Pradet in the Var. However, other less known risk factors exist. “ Anything that comes from combustion can be a cause of COPD, such as the charcoal cooking method in Africa and Asia. There are also all professional causes of inhalation of smoke or phytosanitary products. »
An insidious disease, symptoms to know
COPD is characterized by chronic inflammation of the bronchi and progressive and irreversible obstruction of the small respiratory airways. Very insidious, it evolves over several years quietly, gradually reducing respiratory capacity. “ For example, a smoker who coughs will be considered normal, but this is already a sign that COPD is progressing. The bronchial tree begins to be affected. The other characteristic sign is shortness of breath », Specifies Dr Le Guillou. These symptoms too often go unnoticed. “ We have a real problem identifying COPD because it remains asymptomatic for a very long time. Without forgetting that people do not often want to be put at odds with their tobacco addiction. »
To improve diagnosis, Dr Le Guillou, also president of Santé Respiratoire France, advocates “ to set up a breath measurement for the next prevention consultations at the ages of 25, 45 and 65 which should be implemented soon. This exam is not so easy to carry out and requires specific training. »
Risks for the heart…
COPD, ultimately, affects the entire body and one organ in particular suffers: the heart. “ COPD itself is a cardiovascular risk factor. It considerably increases the risk of myocardial infarction. This is largely explained by the inflammatory mechanisms linked to COPD which will somehow damage the blood vessels. »
Towards more equitable care?
In the care pathway for COPD patients, there is something new this year. “In June 2023, the High Authority of Health estimated that triple therapies could now be initiated by general practitioners and no longer just by pulmonologists. At Respiratory Health France, we fought for this, in order to simplify the patient’s care pathway. Not to mention that it is easier to make an appointment with a general practitioner than with a specialist. This decision has another advantage, that of allowing more consultation time for pulmonologists – because this follow-up remains necessary – to consider the disease and comorbidities in a global manner. This is a real plus for patients. »
Finally, Dr Frédéric Le Guillou wishes to emphasize the importance of compliance. “ We must work to improve patient adherence to their treatments, to reduce the risks of hospitalization and re-hospitalization. We must also think about setting up remote monitoring for the most severe patients. »
For more information
Source : Interview with Dr Frédéric Le Guillou, November 2023 –
Written by : Emmanuel Ducreuzet – Edited by: Vincent Roche
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