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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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				J. Rizkallah, S. F. P. Man, and D. D. Sin Prevalence of Pulmonary Embolism in Acute Exacerbations of COPD: A Systematic Review and Metaanalysis Chest, March 1, 2009; 135(3): 786 - 793. [Abstract] [Full Text] [PDF]

				Y. M.T.A. van Durme, K. M.C. Verhamme, A.-J. L.H.J. Aarnoudse, G. R. Van Pottelberge, A. Hofman, J. C.M. Witteman, G. F. Joos, G. G. Brusselle, and B. H.C. Stricker C-Reactive Protein Levels, Haplotypes, and the Risk of Incident Chronic Obstructive Pulmonary Disease Am. J. Respir. Crit. Care Med., March 1, 2009; 179(5): 375 - 382. [Abstract] [Full Text] [PDF]

				D E O'Donnell, P Laveneziana, J Ora, K A Webb, Y-M Lam, and D Ofir Evaluation of acute bronchodilator reversibility in patients with symptoms of GOLD stage I COPD Thorax, March 1, 2009; 64(3): 216 - 223. [Abstract] [Full Text] [PDF]

				P N Black and C F McDonald Interventions to reduce the frequency of exacerbations of chronic obstructive pulmonary disease Postgrad. Med. J., March 1, 2009; 85(1001): 141 - 147. [Abstract] [Full Text] [PDF]

				M. I. Polkey and K. F. Rabe Chicken or egg: physical activity in COPD revisited Eur. Respir. J., February 1, 2009; 33(2): 227 - 229. [Full Text] [PDF]

				M. Cazzola From large clinical trials to management of COPD in the real world Therapeutic Advances in Respiratory Disease, February 1, 2009; 3(1): 39 - 46. [Abstract] [PDF]

				H. Watz, B. Waschki, T. Meyer, and H. Magnussen Physical activity in patients with COPD Eur. Respir. J., February 1, 2009; 33(2): 262 - 272. [Abstract] [Full Text] [PDF]

				E. J. Lee, K. H. In, J. H. Kim, S. Y. Lee, C. Shin, J. J. Shim, K. H. Kang, S. H. Yoo, C. H. Kim, H.-K. Kim, et al. Proteomic Analysis in Lung Tissue of Smokers and COPD Patients Chest, February 1, 2009; 135(2): 344 - 352. [Abstract] [Full Text] [PDF]

				P. White Prevalence of COPD in primary care: no room for complacency Fam. Pract., February 1, 2009; 26(1): 1 - 2. [Full Text] [PDF]

				D. D. Marciniuk Pulmonary Function Testing ACCP Pulmonary Med Brd Rev, January 1, 2009; 25(0): 187 - 204. [Full Text] [PDF]

				N. B. Volkova, A. Kodani, D. Hilario, S. M. Munyaradzi, and M. W. Peterson Spirometry Utilization After Hospitalization for Patients With Chronic Obstructive Pulmonary Disease Exacerbations American Journal of Medical Quality, January 1, 2009; 24(1): 61 - 66. [Abstract] [PDF]

				J. N. Methvin, D. M. Mannino, and B. R. Casey COPD Prevalence in Southeastern Kentucky: The Burden of Lung Disease Study Chest, January 1, 2009; 135(1): 102 - 107. [Abstract] [Full Text] [PDF]

				H. Iwamoto, A. Yokoyama, Y. Kitahara, N. Ishikawa, Y. Haruta, K. Yamane, N. Hattori, H. Hara, and N. Kohno Airflow Limitation in Smokers Is Associated with Subclinical Atherosclerosis Am. J. Respir. Crit. Care Med., January 1, 2009; 179(1): 35 - 40. [Abstract] [Full Text] [PDF]

				K Jatta, G Eliason, G M Portela-Gomes, L Grimelius, O Caro, L Nilholm, A Sirjso, K Piehl-Aulin, and S M Abdel-Halim Overexpression of von Hippel-Lindau protein in skeletal muscles of patients with chronic obstructive pulmonary disease J. Clin. Pathol., January 1, 2009; 62(1): 70 - 76. [Abstract] [Full Text] [PDF]

				E Barreiro, R Rabinovich, J Marin-Corral, J A Barbera, J Gea, and J Roca Chronic endurance exercise induces quadriceps nitrosative stress in patients with severe COPD Thorax, January 1, 2009; 64(1): 13 - 19. [Abstract] [Full Text] [PDF]

				F. Maltais, J. Bourbeau, S. Shapiro, Y. Lacasse, H. Perrault, M. Baltzan, P. Hernandez, M. Rouleau, M. Julien, S. Parenteau, et al. Effects of Home-Based Pulmonary Rehabilitation in Patients with Chronic Obstructive Pulmonary Disease: A Randomized Trial Ann Intern Med, December 16, 2008; 149(12): 869 - 878. [Abstract] [Full Text] [PDF]

				M. Remy-Jardin and J. Remy Vascular Disease in Chronic Obstructive Pulmonary Disease Proceedings of the ATS, December 15, 2008; 5(9): 891 - 899. [Abstract] [Full Text] [PDF]

				M. Gerhardsson de Verdier The Big Three Concept: A Way to Tackle the Health Care Crisis? Proceedings of the ATS, December 1, 2008; 5(8): 800 - 805. [Abstract] [Full Text] [PDF]

				W. MacNee, J. Maclay, and D. McAllister Cardiovascular Injury and Repair in Chronic Obstructive Pulmonary Disease Proceedings of the ATS, December 1, 2008; 5(8): 824 - 833. [Abstract] [Full Text] [PDF]

				R. Rodriguez-Roisin and J. B. Soriano Chronic Obstructive Pulmonary Disease with Lung Cancer and/or Cardiovascular Disease Proceedings of the ATS, December 1, 2008; 5(8): 842 - 847. [Abstract] [Full Text] [PDF]

				F. Luppi, F. Franco, B. Beghe, and L. M. Fabbri Treatment of Chronic Obstructive Pulmonary Disease and Its Comorbidities Proceedings of the ATS, December 1, 2008; 5(8): 848 - 856. [Abstract] [Full Text] [PDF]

				P. J. Barnes Emerging Pharmacotherapies for COPD Chest, December 1, 2008; 134(6): 1278 - 1286. [Abstract] [Full Text] [PDF]