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Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Pulmonary Disease

GOLD Executive Summary

¹ Leiden University Medical Center, Pulmonology, Leiden, The Netherlands; ² Global Initiative for Chronic Obstructive Lung Disease, Gaithersburg, Maryland; ³ University of Texas Health Science Center, San Antonio, Texas; ⁴ National Heart and Lung Institute, London, United Kingdom; ⁵ Oregon Health and Science University, Portland, Oregon; ⁶ University Hospital Aintree, Liverpool, United Kingdom; ⁷ Asian Pacific Society of Respirology, Tokyo, Japan; ⁸ Woolcock Institute of Medical Research, North Sydney, Australia; ⁹ Hospital Clinic, Barcelona, Spain; ¹⁰ University of Nijmegen, Nijmegen, The Netherlands; and ¹¹ Institute of TB and Lung Diseases, Warsaw, Poland

Correspondence and requests for reprints should be addressed to Prof. Klaus F. Rabe, M.D., Ph.D., Leiden University Medical Center, Pulmonology, P.O. Box 9600, NL-2300 RC, Leiden, The Netherlands. E-mail: k.f.rabe{at}lumc.nl.

Chronic obstructive pulmonary disease (COPD) remains a major public health problem. It is the fourth leading cause of chronic morbidity and mortality in the United States, and is projected to rank fifth in 2020 in burden of disease worldwide, according to a study published by the World Bank/World Health Organization. Yet, COPD remains relatively unknown or ignored by the public as well as public health and government officials. In 1998, in an effort to bring more attention to COPD, its management, and its prevention, a committed group of scientists encouraged the U.S. National Heart, Lung, and Blood Institute and the World Health Organization to form the Global Initiative for Chronic Obstructive Lung Disease (GOLD). Among the important objectives of GOLD are to increase awareness of COPD and to help the millions of people who suffer from this disease and die prematurely of it or its complications. The first step in the GOLD program was to prepare a consensus report, Global Strategy for the Diagnosis, Management, and Prevention of COPD, published in 2001. The present, newly revised document follows the same format as the original consensus report, but has been updated to reflect the many publications on COPD that have appeared. GOLD national leaders, a network of international experts, have initiated investigations of the causes and prevalence of COPD in their countries, and developed innovative approaches for the dissemination and implementation of COPD management guidelines. We appreciate the enormous amount of work the GOLD national leaders have done on behalf of their patients with COPD. Despite the achievements in the 5 years since the GOLD report was originally published, considerable additional work is ahead of us if we are to control this major public health problem. The GOLD initiative will continue to bring COPD to the attention of governments, public health officials, health care workers, and the general public, but a concerted effort by all involved in health care will be necessary.

Key Words: COPD • guidelines • human • chronic disease

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				M. M. de Oca, C. Talamo, R. J. Halbert, R. Perez-Padilla, M. V. Lopez, A. Muino, J. R. B. Jardim, G. Valdivia, J. Pertuze, D. Moreno, et al. Frequency of Self-Reported COPD Exacerbation and Airflow Obstruction in Five Latin American Cities: The Proyecto Latinoamericano de Investigacion en Obstruccion Pulmonar (PLATINO) Study Chest, July 1, 2009; 136(1): 71 - 78. [Abstract] [Full Text] [PDF]

				M. M. Hoeper, J. A. Barbera, R. N. Channick, P. M. Hassoun, I. M. Lang, A. Manes, F. J. Martinez, R. Naeije, H. Olschewski, J. Pepke-Zaba, et al. Diagnosis, assessment, and treatment of non-pulmonary arterial hypertension pulmonary hypertension. J. Am. Coll. Cardiol., June 30, 2009; 54(1 Suppl): S85 - S96. [Abstract] [Full Text] [PDF]

				M. G. Cosio, M. Saetta, and A. Agusti Immunologic Aspects of Chronic Obstructive Pulmonary Disease N. Engl. J. Med., June 4, 2009; 360(23): 2445 - 2454. [Full Text] [PDF]

				A. Lacoma, C. Prat, F. Andreo, and J. Dominguez Biomarkers in the management of COPD Eur. Respir. Rev., June 1, 2009; 18(112): 96 - 104. [Abstract] [Full Text] [PDF]

				N. Sverzellati, E. Calabro, G. Randi, C. La Vecchia, A. Marchiano, J-M. Kuhnigk, M. Zompatori, P. Spagnolo, and U. Pastorino Sex differences in emphysema phenotype in smokers without airflow obstruction Eur. Respir. J., June 1, 2009; 33(6): 1320 - 1328. [Abstract] [Full Text] [PDF]

				J. Marin-Corral, J. Minguella, A. L. Ramirez-Sarmiento, S. N. A. Hussain, J. Gea, and E. Barreiro Oxidised proteins and superoxide anion production in the diaphragm of severe COPD patients Eur. Respir. J., June 1, 2009; 33(6): 1309 - 1319. [Abstract] [Full Text] [PDF]

				D. A. Ngan, S. V. Vickerman, D. J. Granville, S. F. P. Man, and D. D. Sin The possible role of granzyme B in the pathogenesis of chronic obstructive pulmonary disease Therapeutic Advances in Respiratory Disease, June 1, 2009; 3(3): 113 - 129. [Abstract] [PDF]

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				H. R. Gosker, R. C. J. Langen, K. R. Bracke, G. F. Joos, G. G. Brusselle, C. Steele, K. A. Ward, E. F. M. Wouters, and A. M. W. J. Schols Extrapulmonary Manifestations of Chronic Obstructive Pulmonary Disease in a Mouse Model of Chronic Cigarette Smoke Exposure Am. J. Respir. Cell Mol. Biol., June 1, 2009; 40(6): 710 - 716. [Abstract] [Full Text] [PDF]

				J. Paulo Araujo, P. Lourenco, F. Rocha-Goncalves, A. Ferreira, and P. Bettencourt Adiponectin is increased in cardiac cachexia irrespective of body mass index Eur J Heart Fail, June 1, 2009; 11(6): 567 - 572. [Abstract] [Full Text] [PDF]

				C. Jenkins and R. Rodriguez-Roisin Quality of life, stage severity and COPD Eur. Respir. J., May 1, 2009; 33(5): 953 - 955. [Full Text] [PDF]

				K Ansari, M Shamssain, M Farrow, and N. Keaney Hospital-at-home care for exacerbations of chronic obstructive pulmonary disease: an observational cohort study of patients managed in hospital or by nurse practitioners in the community Chronic Respiratory Disease, May 1, 2009; 6(2): 69 - 74. [Abstract] [PDF]

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				P. B. Koff, R. H. Jones, J. M. Cashman, N. F. Voelkel, and R. W. Vandivier Proactive integrated care improves quality of life in patients with COPD Eur. Respir. J., May 1, 2009; 33(5): 1031 - 1038. [Abstract] [Full Text] [PDF]

				A. Kjensli, J. A. Falch, M. Ryg, T. Blenk, G. Armbrecht, L. M. Diep, and I. Ellingsen High prevalence of vertebral deformities in COPD patients: relationship to disease severity Eur. Respir. J., May 1, 2009; 33(5): 1018 - 1024. [Abstract] [Full Text] [PDF]

				G. Devouassoux, V. Cottin, H. Liote, E. Marchand, I. Frachon, A. Schuller, F. Bejui-Thivolet, J-F. Cordier, and the Groupe d'Etudes et de Recherche sur les Maladi Characterisation of severe obliterative bronchiolitis in rheumatoid arthritis Eur. Respir. J., May 1, 2009; 33(5): 1053 - 1061. [Abstract] [Full Text] [PDF]

				L. Puente-Maestu, J. Perez-Parra, R. Godoy, N. Moreno, A. Tejedor, F. Gonzalez-Aragoneses, J-L. Bravo, F. Villar Alvarez, S. Camano, and A. Agusti Abnormal mitochondrial function in locomotor and respiratory muscles of COPD patients Eur. Respir. J., May 1, 2009; 33(5): 1045 - 1052. [Abstract] [Full Text] [PDF]

				J. Vestbo, L. Tan, G. Atkinson, J. Ward, and on behalf of the UK-500,001 Global Study Team A controlled trial of 6-weeks' treatment with a novel inhaled phosphodiesterase type-4 inhibitor in COPD Eur. Respir. J., May 1, 2009; 33(5): 1039 - 1044. [Abstract] [Full Text] [PDF]

				S. G. Kelsen, M. O. Aksoy, M. Georgy, R. Hershman, R. Ji, X. Li, M. Hurford, C. Solomides, W. Chatila, and V. Kim Lymphoid Follicle Cells in Chronic Obstructive Pulmonary Disease Overexpress the Chemokine Receptor CXCR3 Am. J. Respir. Crit. Care Med., May 1, 2009; 179(9): 799 - 805. [Abstract] [Full Text] [PDF]