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Published ahead of print on May 16, 2007, doi:10.1164/rccm.200703-456SO
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American Journal of Respiratory and Critical Care Medicine Vol 176. pp. 532-555, (2007)
© 2007 American Thoracic Society
doi: 10.1164/rccm.200703-456SO


Original Article

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

GOLD Executive Summary

Klaus F. Rabe1, Suzanne Hurd2, Antonio Anzueto3, Peter J. Barnes4, Sonia A. Buist5, Peter Calverley6, Yoshinosuke Fukuchi7, Christine Jenkins8, Roberto Rodriguez-Roisin9, Chris van Weel10 and Jan Zielinski11

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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Dichloroacetate Modulates the Oxidative Stress and Inflammatory Response to Exercise in COPD
Chest, September 1, 2009; 136(3): 744 - 751.
[Abstract] [Full Text] [PDF]


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J. Immunol.Home page
R. Shaykhiev, A. Krause, J. Salit, Y. Strulovici-Barel, B.-G. Harvey, T. P. O'Connor, and R. G. Crystal
Smoking-Dependent Reprogramming of Alveolar Macrophage Polarization: Implication for Pathogenesis of Chronic Obstructive Pulmonary Disease
J. Immunol., August 15, 2009; 183(4): 2867 - 2883.
[Abstract] [Full Text] [PDF]


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Eur Respir JHome page
V. Brusasco
Statistically significant or clinically useful? From population studies to patient care
Eur. Respir. J., August 1, 2009; 34(2): 291 - 292.
[Full Text] [PDF]


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ChestHome page
D. D. Sin
Is COPD Really a Cardiovascular Disease?
Chest, August 1, 2009; 136(2): 329 - 330.
[Full Text] [PDF]


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Eur Respir JHome page
L. Puente-Maestu, F. Villar, J. de Miguel, W. W. Stringer, P. Sanz, M. L. Sanz, J. Garcia de Pedro, and Y. Martinez-Abad
Clinical relevance of constant power exercise duration changes in COPD
Eur. Respir. J., August 1, 2009; 34(2): 340 - 345.
[Abstract] [Full Text] [PDF]


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J. Pharmacol. Exp. Ther.Home page
P. Casarosa, T. Bouyssou, S. Germeyer, A. Schnapp, F. Gantner, and M. Pieper
Preclinical Evaluation of Long-Acting Muscarinic Antagonists: Comparison of Tiotropium and Investigational Drugs
J. Pharmacol. Exp. Ther., August 1, 2009; 330(2): 660 - 668.
[Abstract] [Full Text] [PDF]


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ChestHome page
W. J. Kim, E. K. Silverman, E. Hoffman, G. J. Criner, Z. Mosenifar, F. C. Sciurba, B. J. Make, V. Carey, R. S. J. Estepar, A. Diaz, et al.
CT Metrics of Airway Disease and Emphysema in Severe COPD
Chest, August 1, 2009; 136(2): 396 - 404.
[Abstract] [Full Text] [PDF]


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ChestHome page
D. Stav and M. Raz
Effect of N-Acetylcysteine on Air Trapping in COPD: A Randomized Placebo-Controlled Study
Chest, August 1, 2009; 136(2): 381 - 386.
[Abstract] [Full Text] [PDF]


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Eur Respir JHome page
S. Suissa and P. J. Barnes
Inhaled corticosteroids in COPD: the case against
Eur. Respir. J., July 1, 2009; 34(1): 13 - 16.
[Full Text] [PDF]


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Eur Respir JHome page
L. Graat-Verboom, E. F. M. Wouters, F. W. J. M. Smeenk, B. E. E. M. van den Borne, R. Lunde, and M. A. Spruit
Current status of research on osteoporosis in COPD: a systematic review
Eur. Respir. J., July 1, 2009; 34(1): 209 - 218.
[Abstract] [Full Text] [PDF]


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Eur Respir JHome page
D. A. Lomas, E. K. Silverman, L. D. Edwards, N. W. Locantore, B. E. Miller, D. H. Horstman, R. Tal-Singer, and on behalf of the Evaluation of COPD Longitudinally
Serum surfactant protein D is steroid sensitive and associated with exacerbations of COPD
Eur. Respir. J., July 1, 2009; 34(1): 95 - 102.
[Abstract] [Full Text] [PDF]


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Eur Respir JHome page
N. N. Hansel, L. Gao, N. M. Rafaels, R. A. Mathias, E. R. Neptune, C. Tankersley, A. V. Grant, J. Connett, T. H. Beaty, R. A. Wise, et al.
Leptin receptor polymorphisms and lung function decline in COPD
Eur. Respir. J., July 1, 2009; 34(1): 103 - 110.
[Abstract] [Full Text] [PDF]


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J. Appl. Physiol.Home page
G. R. Washko, M. T. Dransfield, R. S. J. Estepar, A. Diaz, S. Matsuoka, T. Yamashiro, H. Hatabu, E. K. Silverman, W. C. Bailey, and J. J. Reilly
Airway wall attenuation: a biomarker of airway disease in subjects with COPD
J Appl Physiol, July 1, 2009; 107(1): 185 - 191.
[Abstract] [Full Text] [PDF]


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ChestHome page
M. J. H. Sillen, C. M. Speksnijder, R.-M. A. Eterman, P. P. Janssen, S. S. Wagers, E. F. M. Wouters, N. H. M. K. Uszko-Lencer, and M. A. Spruit
Effects of Neuromuscular Electrical Stimulation of Muscles of Ambulation in Patients With Chronic Heart Failure or COPD: A Systematic Review of the English-Language Literature
Chest, July 1, 2009; 136(1): 44 - 61.
[Abstract] [Full Text] [PDF]


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ChestHome page
J. Garcia-Aymerich, I. Serra, F. P. Gomez, E. Farrero, E. Balcells, D. A. Rodriguez, J. de Batlle, E. Gimeno, D. Donaire-Gonzalez, M. Orozco-Levi, et al.
Physical Activity and Clinical and Functional Status in COPD
Chest, July 1, 2009; 136(1): 62 - 70.
[Abstract] [Full Text] [PDF]


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ChestHome page
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]


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J Am Coll CardiolHome page
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]


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NEJMHome page
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]


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ERRHome page
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]


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Eur Respir JHome page
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]


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Eur Respir JHome page
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]


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Ther Adv Respir DisHome page
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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J. Appl. Physiol.Home page
R. Rodriguez-Roisin, M. Drakulovic, D. A. Rodriguez, J. Roca, J. A. Barbera, and P. D. Wagner
Ventilation-perfusion imbalance and chronic obstructive pulmonary disease staging severity
J Appl Physiol, June 1, 2009; 106(6): 1902 - 1908.
[Abstract] [Full Text] [PDF]


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Am. J. Respir. Cell Mol. Bio.Home page
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]


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Eur J Heart FailHome page
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]


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Eur Respir JHome page
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]


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Chronic Respiratory DiseaseHome page
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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ChestHome page
R. Kohansal, J. B. Soriano, and A. Agusti
Investigating the Natural History of Lung Function: Facts, Pitfalls, and Opportunities
Chest, May 1, 2009; 135(5): 1330 - 1341.
[Abstract] [Full Text] [PDF]


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Eur Respir JHome page
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]


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Eur Respir JHome page
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]


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Eur Respir JHome page
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]


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Eur Respir JHome page
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]


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Eur Respir JHome page
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]


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Am. J. Respir. Crit. Care Med.Home page
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]




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