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Baral N, Jabbar ABA, Noor A, Mirza M, DeVrieze B, Hildenbrand A, Tauseef A. Demographic and geographical trends in chronic lower respiratory diseases mortality in the United States, 1999 to 2020. Respir Res 2024; 25:258. [PMID: 38915019 PMCID: PMC11197268 DOI: 10.1186/s12931-024-02880-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2024] [Accepted: 06/12/2024] [Indexed: 06/26/2024] Open
Abstract
Chronic lower respiratory disease (CLRD) related mortality has decreased in the United States due to increasing awareness in the general population and advancing preventative efforts, diagnostic measures, and treatment. However, demographic and regional differences still persist throughout the United States. In this study, we analyzed the temporal trends of demographic and geographical differences in CLRD-related mortality. Data was extracted from the Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research (CDC WONDER) database. Using this data, age-adjusted mortality rates per 100,000 people (AAMR), annual percentage change (APC), and average annual percentage changes with 95% confidence intervals (CIs) were assessed. The Joinpoint Regression Program was used to determine mortality trends between 1999 and 2020 based on demographic and regional groups.During this study period, there were 3,064,049 CLRD-related deaths, with most demographics and regional areas showing an overall decreasing trend. However, higher mortality rates were seen in the non-Hispanic White population and rural areas. Interestingly, mortality rates witnessed a decreasing trend for males throughout the study duration compared to females, who only began to show decreases in mortality during the latter half of the 2010s. Using these results, one can target efforts and build policies to improve CLRD-related mortality and reduce disparities in the coming decades.
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Affiliation(s)
- Nikita Baral
- Creighton University School of Medicine, Omaha, NE, USA.
| | - Ali Bin Abdul Jabbar
- Department of Internal Medicine, Creighton University Medical Center, Omaha, NE, USA
| | | | - Mohsin Mirza
- Department of Internal Medicine, Creighton University Medical Center, Omaha, NE, USA
| | - Bradley DeVrieze
- Department of Internal Medicine, Creighton University Medical Center, Omaha, NE, USA
| | - Alec Hildenbrand
- Department of Internal Medicine, Creighton University Medical Center, Omaha, NE, USA
| | - Abubakar Tauseef
- Department of Internal Medicine, Creighton University Medical Center, Omaha, NE, USA
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Krishnan JK, Murphy ML, Edgar AS, Aronson KI, Guri A, Gross L, Younger T, Martinez FJ, Safford MM. Perspectives of Black Adults Living with Chronic Obstructive Pulmonary Disease on Barriers to Cardiovascular Disease Prevention. Ann Am Thorac Soc 2024; 21:706-715. [PMID: 38079490 PMCID: PMC11109915 DOI: 10.1513/annalsats.202304-342oc] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 12/08/2023] [Indexed: 05/02/2024] Open
Abstract
Rationale: Cardiovascular disease (CVD) is a leading cause of morbidity and mortality among individuals with chronic obstructive pulmonary disease (COPD). Black women with COPD are at elevated risk of CVD-related mortality compared with White women. CVD risk factors are undertreated in Black men and women. However, barriers to CVD prevention from the perspective of Black individuals living with COPD have not been previously identified. Objectives: To identify barriers and facilitators for CVD prevention among Black individuals living with COPD. Methods: We conducted semistructured interviews with Black participants living with COPD and attending clinics at two urban hospitals. Participants were included if they had physician-confirmed COPD diagnoses and presence of CVD or CVD risk factors. Interviews were conducted until thematic saturation was reached, with additional interviews conducted to confirm saturation. Data were analyzed using thematic analysis, iteratively revising and updating the codebook by consensus of the study team. Codes were grouped into categories, subthemes, and themes. Themes were organized using the social ecological framework into individual, interpersonal, health system, and societal levels. Results: We interviewed 30 participants of mean age 67.8 ± 8.3 years; 17 (57%) were Black women and 13 (43%) were Black men. Individual-level themes were that living with COPD and resultant multimorbidity affects CVD prevention (theme 1) and that self-efficacy and advocacy affect care received (theme 2). At the interpersonal level, supportive relationships facilitate improved access to CVD prevention (theme 3). System-level themes were that health systems are not designed to support patients with COPD and CVD (theme 4) and that health systems do not deliver effective patient education (theme 5). At the societal level, structural barriers and racism prevent access to care and adoption of a healthy lifestyle (theme 6). Conclusions: We identified barriers to CVD prevention at all levels of the socioecological framework for Black individuals living with COPD. To maximize their impact, future interventions to prevent CVD among individuals with COPD can use these findings to target barriers at multiple levels.
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Affiliation(s)
| | - Michaela L. Murphy
- Internal Medicine and
- Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, University of Miami Health System, Miami, Florida
| | | | | | - Albina Guri
- Pulmonary and Critical Care, Brooklyn Methodist Hospital, Brooklyn, New York
| | - Liam Gross
- Pulmonary and Critical Care, Brooklyn Methodist Hospital, Brooklyn, New York
- Montefiore Nyack Hospital, Nyack, New York; and
| | - Tiffany Younger
- Graduate Center for Social Welfare, City University of New York, New York, New York
| | | | - Monika M. Safford
- Division of General Internal Medicine, Joan and Sanford I. Weill Department of Medicine, Weill Cornell Medicine, New York, New York
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Chen L, Deng Y, Wang T, Lin X, Zheng L, Chen X, Chen T. Tea consumption and risk of lung diseases: a two‑sample Mendelian randomization study. BMC Pulm Med 2023; 23:461. [PMID: 37993830 PMCID: PMC10664472 DOI: 10.1186/s12890-023-02762-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 11/14/2023] [Indexed: 11/24/2023] Open
Abstract
BACKGROUND Numerous studies have reported the association between tea intake and lung diseases. However, the probable relationship between tea consumption on lung diseases still remain controversial and it is unclear whether these findings are due to reverse causality or confounding factor. METHODS In order to systematically investigate the causal connection between tea intake on respiratory system disorders, we employed a two-sample Mendelian randomized (MR) study. Genetic instruments for tea intake were identified from a genome-wide association study (GWAS) involving 447,385 individuals. Data on lung diseases were collected from a variety of publicly available genome-wide association studies. The main method used for MR analysis is the inverse variance weighting (IVW) method. To ensure the accuracy of the findings, further sensitivity analysis was conducted. RESULTS The IVW method in our MR analysis revealed no evidence to support a causal relationship between tea intake and lung diseases (IPF: OR = 0.997, 95% CI = 0.994-1.000, p = 0.065; Lung cancer: OR = 1.003, 95% CI = 0.998-1.008, P = 0.261; COPD: OR = 1.001, 95% CI = 0.993-1.006, p = 0.552; acute bronchitis: OR = 0.919, 95% CI = 0.536-1.576, p = 0.759; tuberculosis: OR = 1.002, 95% CI = 0.998-1.008, p = 0.301; pneumonia: OR = 0.789, 95% CI = 0.583-1.068, p = 0.125). The reliability of the results was further demonstrated by four additional MR analysis techniques and additional sensitivity testing. CONCLUSION We found no evidence of a link between tea intake on lung diseases in our MR results based on genetic information.
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Affiliation(s)
- Linjie Chen
- Institute of Respiratory Diseases, Xiamen Medical College, Xiamen, Fujian Province, 361023, P.R. China
- Fujian Provincial Key Laboratory of Functional and Clinical Translational Medicine, Xiamen Medical College, Xiamen, Fujian Province, 361023, P.R. China
- Department of Clinical Medicine, Xiamen Medical College, Xiamen, Fujian Province, 361023, P.R. China
| | - Yaru Deng
- Institute of Respiratory Diseases, Xiamen Medical College, Xiamen, Fujian Province, 361023, P.R. China
- Fujian Provincial Key Laboratory of Functional and Clinical Translational Medicine, Xiamen Medical College, Xiamen, Fujian Province, 361023, P.R. China
| | - Tiexu Wang
- Institute of Respiratory Diseases, Xiamen Medical College, Xiamen, Fujian Province, 361023, P.R. China
- Fujian Provincial Key Laboratory of Functional and Clinical Translational Medicine, Xiamen Medical College, Xiamen, Fujian Province, 361023, P.R. China
| | - Xinyu Lin
- Institute of Respiratory Diseases, Xiamen Medical College, Xiamen, Fujian Province, 361023, P.R. China
- Fujian Provincial Key Laboratory of Functional and Clinical Translational Medicine, Xiamen Medical College, Xiamen, Fujian Province, 361023, P.R. China
| | - Lukun Zheng
- Institute of Respiratory Diseases, Xiamen Medical College, Xiamen, Fujian Province, 361023, P.R. China
- Fujian Provincial Key Laboratory of Functional and Clinical Translational Medicine, Xiamen Medical College, Xiamen, Fujian Province, 361023, P.R. China
| | - Xiaohong Chen
- Institute of Respiratory Diseases, Xiamen Medical College, Xiamen, Fujian Province, 361023, P.R. China.
- Fujian Provincial Key Laboratory of Functional and Clinical Translational Medicine, Xiamen Medical College, Xiamen, Fujian Province, 361023, P.R. China.
| | - Tongsheng Chen
- Institute of Respiratory Diseases, Xiamen Medical College, Xiamen, Fujian Province, 361023, P.R. China.
- Fujian Provincial Key Laboratory of Functional and Clinical Translational Medicine, Xiamen Medical College, Xiamen, Fujian Province, 361023, P.R. China.
- Department of Physiology, Xiamen Medical College, Xiamen, Fujian Province, 361023, P.R. China.
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Krishnan JK, Mallya SG, Nahid M, Baugh AD, Han MK, Aronson KI, Goyal P, Pinheiro LC, Banerjee S, Martinez FJ, Safford MM. Disparities in Guideline Concordant Statin Treatment in Individuals With Chronic Obstructive Pulmonary Disease. CHRONIC OBSTRUCTIVE PULMONARY DISEASES (MIAMI, FLA.) 2023; 10:369-379. [PMID: 37410623 PMCID: PMC10699489 DOI: 10.15326/jcopdf.2023.0395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/29/2023] [Indexed: 07/08/2023]
Abstract
Rationale Cardiovascular disease (CVD) affects the prognosis of patients with chronic obstructive pulmonary disease (COPD). Black women with COPD have a disproportionate risk of CVD-related mortality, yet disparities in CVD prevention in COPD are unknown. Objectives We aimed to identify race-sex differences in the receipt of statin treatment for CVD prevention, and whether these differences were explained by factors influencing health care utilization in the REasons for Geographic And Racial Differences in Stroke (REGARDS) COPD study sub-cohort. Methods We conducted a cross-sectional analysis among REGARDS Medicare beneficiaries with COPD. Our primary outcome was the presence of statin on in-home pill bottle review among individuals with an indication. Prevalence ratios (PR) for statin treatment among race-sex groups compared to White men were estimated using Poisson regression with robust variance. We then adjusted for covariates previously shown to impact health care utilization. Results Of the 2032 members within the COPD sub-cohort with sufficient data, 1435 participants (19% Black women, 14% Black men, 28% White women, and 39% White men) had a statin indication. All race-sex groups were less likely to receive statins than White men in unadjusted models. After adjusting for covariates that influence health care utilization, Black women (PR 0.76, 95% confidence interval [CI] 0.67 to 0.86) and White women (PR 0.84 95% CI 0.76 to 0.91) remained less likely to be treated compared to White men. Conclusions All race-sex groups were less likely to receive statin treatment in the REGARDS COPD sub-cohort compared to White men. This difference persisted in women after controlling for individual health care utilization factors, suggesting structural interventions are needed.
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Affiliation(s)
- Jamuna K. Krishnan
- Division of Pulmonary and Critical Care Medicine, Weill Cornell Medicine, New York, New York, United States
| | - Sonal G. Mallya
- Division of Pulmonary and Critical Care Medicine, School of Medicine, Johns Hopkins University, Baltimore, Maryland, United States
- Division of General Internal Medicine, Weill Cornell Medicine, New York, New York, United States
| | - Musarrat Nahid
- Division of General Internal Medicine, Weill Cornell Medicine, New York, New York, United States
| | - Aaron D. Baugh
- Division of Pulmonary, Critical Care, Allergy, and Sleep Medicine, University of California San Francisco, San Francisco, California, United States
| | - MeiLan K. Han
- Division of Pulmonary and Critical Care Medicine, University of Michigan Health System, Ann Arbor, Michigan, United States
| | - Kerri I. Aronson
- Division of Pulmonary and Critical Care Medicine, Weill Cornell Medicine, New York, New York, United States
| | - Parag Goyal
- Division of General Internal Medicine, Weill Cornell Medicine, New York, New York, United States
- Division of Cardiology, Weill Cornell Medicine, New York, New York, United States
| | - Laura C. Pinheiro
- Division of General Internal Medicine, Weill Cornell Medicine, New York, New York, United States
| | - Samprit Banerjee
- Department of Population Health Sciences, Weill Cornell Medicine, New York, New York, United States
| | - Fernando J. Martinez
- Division of Pulmonary and Critical Care Medicine, Weill Cornell Medicine, New York, New York, United States
| | - Monika M. Safford
- Division of General Internal Medicine, Weill Cornell Medicine, New York, New York, United States
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Maestri R, Vitacca M, Paneroni M, Zampogna E, Ambrosino N. Gender and Age as Determinants of Success of Pulmonary Rehabilitation in Individuals With Chronic Obstructive Pulmonary Disease. Arch Bronconeumol 2023; 59:174-177. [PMID: 36192251 DOI: 10.1016/j.arbres.2022.09.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 08/30/2022] [Accepted: 09/08/2022] [Indexed: 11/18/2022]
Affiliation(s)
- Roberto Maestri
- Department of Biomedical Engineering of the Institute of Montescano, Istituti Clinici Scientifici Maugeri IRCCS, Montescano, Pavia, Italy
| | - Michele Vitacca
- Respiratory Rehabilitation of the Institute of Lumezzane, Istituti Clinici Scientifici Maugeri IRCCS, Lumezzane, Brescia, Italy.
| | - Mara Paneroni
- Respiratory Rehabilitation of the Institute of Lumezzane, Istituti Clinici Scientifici Maugeri IRCCS, Lumezzane, Brescia, Italy
| | - Elisabetta Zampogna
- Respiratory Rehabilitation of the Institute of Tradate, Istituti Clinici Scientifici Maugeri IRCCS, Tradate, Varese, Italy
| | - Nicolino Ambrosino
- Respiratory Rehabilitation of the Institute of Montescano, Istituti Clinici Scientifici Maugeri IRCCS, Montescano, Pavia, Italy
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Chronic Obstructive Pulmonary Disease in the LGBTQI + Population. Ann Am Thorac Soc 2022; 19:2111-2112. [PMID: 36103717 PMCID: PMC9743471 DOI: 10.1513/annalsats.202207-653le] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
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Krishnan JK, Safford MM. Reply: Chronic Obstructive Pulmonary Disease in the LGBTQI+ Population. Ann Am Thorac Soc 2022; 19:2112-2113. [PMID: 36103714 PMCID: PMC9743478 DOI: 10.1513/annalsats.202209-752le] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
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