Seven questions


Select one (1) peer-reviewed research article that you used in your research paper to share with the class.  Do not discuss en editorial or letter to editor.  

After reading your selected article, post the following information: 
1. Why is the research question significant to your research paper?   
2. What was the purpose of the study?  
3. What was the study design?  
4. Who was in the study population(s)/sample(s)? 
5. What was the outcome and was it consistent with the researcher(s)’ original research question?  
6. What recommendation(s) did the researcher offer for future studies?  
7. How do you know this article was peer-reviewed?     OBSTRUCTIVE PULMONARY  DI SEASE (COPD)                 1










Chronic Obstructive Pulmonary Disease ( COPD )















Chronic Obstructive Pulmonary Disease ( COPD )


A chronic obstructive pulmonary disease (COPD) is one of the current killers in the world. It is a preventable disease that makes it difficult for the affected individual to empty air out of the lungs otherwise referred to as airflow obstruction. The difficulties in breathing that is brought about by this condition leaves one feeling tired because they use  much  energy to  breathe  than required.  The c hronic  obstructive pulmonary disease is a term that is used to include other types of pulmonary diseases that include chronic bronchitis, emphysema or both. Although asthma is a health condition that results in difficulties in breathing it is not included among the chronic obstructive pulmonary disease.  The effects of the disease are not instant but rather evolve at a slower rate inhibiting the breathing system of a patient.  However,  the  most important thing to note is that the disease can  be prevented  and it is relatively easier when it  is detected  in its earlier stages than in advanced stage.

In the United States, between 10 % and 20% of the chronic obstructive pulmonary disease is said to have been caused by occupational or exposure to chemical vapors,  irritants ,  and fumes which are very much contaminated. A  large  percentage of patients who are suffering from COPD are said to be  smokers ,  but a recent research indicated that 25 % of patients with COPD have never smoked in the United States. This paper provides an in-depth analysis into chronic obstructive pulmonary diseases including the historical perspective,  symptoms, and causes  of COPD, method of spread, how it can  be contained , and its implication on the economy,  treatment ,  and efforts being put in place to ensure that the disease is  contained .


COPD,  Chronic, Obstructive. Bronchodilators,  Pulmonary,   Prevalence, Mortality .

History of the diseases

The c hronic  obstructive pulmonary disease has been in existence for the last 200  years; the only difference is that its prevalence back in the day was much lower mainly because of  the lower  presence of risk factors than they are currently.  The disease  was recognized  by the use of stethoscope and spirometer. Spirometer up to date remains the most efficient method of identifying chronic obstructive pulmonary disease and its respond to therapy. The disease is ranked 4 th  amongst  the  United States  killer disease this shows that the  disease  has indeed evolved because of the high presence of risk factors.  It  is estimated  by various scientific studies done that chronic obstructive pulmonary disease will be the third largest killer in the  United States  if  the situation  is not contained  ( Barnes, 2012, p.38 ).

The earliest incidences of chronic obstructive pulmonary disease 

The very  earliest   symptom of COPD was   experienced  in the year 1679 although it  was not directly identified . It  was described  as voluminous lungs . The lungs of the patients were said to be turgid at the time. In 1789, Baillie published  a long  documentation highlighting the emphysematous lung which put forth the pathology of the disease. Emphysema was the known type of COPD that occurred very long ago. Jon Hutchison is the brain behind the spirometer which was the commonly used instrument to carry out tests on patients  to  evaluate if they had the COPD in the year 1846. The spirometer  is  still used  in current settings (Barnes, 2012, p.56).








Symptoms of COPD

The symptoms of the chronic obstructive pulmonary disease don not always appear in initial periods but rather take  the   time  to show up especially after excessive lung damage. It is  very important   for   a patient  or anyone who develops some uncommon  symptoms  to visit a healthcare facility to conduct tests  to  be  quite sure  that there is  no such like condition in play (Littner, 2011, p.23).

The most common symptom of COPD is shortness of breath especially after a short physical exercise or even under  little  tension. This occurs  mainly  when the effect on the lungs has started being severe and an individual having shortness of breath should consider  visiting a health facility  to  be  fully  aware of the extent of  his or her problem (Littner, 2011, p.28).

Another symptom to note is that there is always  the   presence  of mucus in the lungs thus an individual has to clear their throat first thing in the morning on  a   daily  basis.

An individual who has this condition has  excessive respiratory infections because the immune system is  low  and cannot be able to fight even the smallest of the infections in the respiratory system. The disease already weakens the system.

In later stages of the  disease ,  a  patient undergoes  severe  weight loss because the body cannot  specifically  operate  norm ally  as some functionality are already   being subjected  to numerous activities in fighting the disease thus preventing the other parts of the  busy  receive the service needed.

Patients  are  suffering from chronic obstructive pulmonary disease also are subjected to chest tightness due to the difficulties that the heart undergoes in ensuring that the breathing system is  regulated ,  and body continues to function normally. However, the massive damage to the lungs makes the whole process even more  difficult  (Littner, 2011, p.51).

The  patients  also  suffer  from blueness of the lips or fingernails otherwise referred to as cyanosis. The condition  ar ose  from  poor circulation of blood or in situations  when the  blood supplied has not been properly subjected to all the stages hence missing the  important oxygenation.

Individuals having  the   chronic  obstructive pulmonary  disease have  high chances of experiencing  exacerbations, where the symptoms of the disease become worse every single  day , and the variations tend to occur for several days or weeks.

It is also important to note that not everyone who has COPD has the  symptoms mentioned  above ,  and it is not true that everyone who has  the above-mentioned symptoms  suffer from the disease. It is  imperative  for individuals to consider having regular medical checks  to know their physical and mental state  about  various diseases that tend to have silent symptoms and that the symptoms only arise when the conditions  are  very critical thus risking their life and state of well-being for other individuals. Medical centers are well equipped with diagnosing  equipment  thus are authorized to carry out tests on patients  to  kno w  what type of disease  is one suffering from (Barnes, 2012, p.59) .

The causes of chronic obstructive pulmonary diseases

The prevalence of COPD is recent days has been on the  rise ,  and this can  be attributed  to the increase in risk factors that are brought about by industrialization.  The disease  was on  the lower  side in the 20 th  century because the risk factors were not as many as currently being witnessed. Individuals are regularly subjected to these conditions making it difficult to control and manage. The  causes  of the disease range from biological to environmental and it is im portant to understand the  causes  so that to be better placed to develop any control measure to deal with these  risk factors  (Barnes, 2012, p.64).

The most common causes of the chronic obstructive pulmonary disease in  a   developed country is tobacco smoking while  in developing countries  the COPD occurs to individuals who are exposed to fumes  and other   strong  chemicals and also cooking in poorly ventilated homes.

Research  shows that only 25 %  of chronic smokers end up developing  clinically  associated COPD. Some smokers  often   develop   lesser-known lung  conditions. Many smokers  are misdiagnosed  to the effect of  the   presence  of COPD but until further  tests  are conducted to provide  a true  statement about their conditions.  It is a common perception the chronic obstructive pulmonary  disease  is mainly for  smokers ,   but this is far from the truth. T he current  research studies done  indicate  that lately many non- smokers  are  being diagnosed  with the  disease  which raises more questions as to what are some of the risk factors associated with this fast growing disease  in the  U nited   S tates   (Barnes, 2012, p.69).

Biological causatives

Some researches  have  been conducted indicating that COPD can result from a genetic disorder in an individual. The genetic disorder causes  the   presence  of low levels of  a certain protein cell that is called alpha-1 antitrypsin. This protein cell is made in the liver and secreted straight  into the  bloodstream to  offer  protective support to the lungs.  Thus,  the presence of lower  levels the  alpha-1  antitrypsin in  the body leaves the lungs barely protected and increase the risks  of being  caught out by the disease with ease.  Thus,  it is important to conduct various medical tests to be in a better po sition to deal with the outcome (Littner, 2011, p.88).

Another cause for the chronic obstructive pulmonary  diseases  is the presence of under-treated asthma in an  individual’s  body.  In this situation, the  respiratory ,  immune system is already  overworked  dealing with  asthma  making it easier for a different type of disease to  easily enter the body of a patient. In this case, the COPD is said to be an opportunistic  disease .

The presence of industrial fumes and chemical all over the place brought about by massive industrialization has become the latest risk factor  in causing  the COPD . Individuals who leave close to these industries  have high  chances of developing COPD because they  high  inhale this fumes and  chemicals, which  are untreated as they  are  released  into the atmosphere by these  industries .   In the  United States , chemicals and fumes inhalation has become one of the major causative agents of the COPD  and the  research  shows  that by  the year 20130 if the  current situation is not  contained these  will be the highest causative agent for the chronic obstructive pulmonary disease in the  United States  and all the d eveloped countries (Littner, 2011, p.117).

Method of spread

In the  United States , approximately  24  million individuals are infected with this condition . The 12 million individuals have  been diagnosed ;  there  are higher chances that many more individuals may be affected by the disease but are not aware of the same because the  disease  is still in early stages or they  are not exposed  to highly technological machines that can  effectively  detect the presence of COPD in the body.

How the lungs are affected by the COPD

In a medically  normal  person, the inhaled air travels down from the trachea to the lungs through bronchi. Inside the lungs, the tubes  divide   severally into   bronchioles that  are  much smaller. The bronchioles deliver the inhaled air into the  alveoli that  are otherwise known as  air sacs . The  air sacs  comprise of  thin  walls  that   are filled  with small  blood  vessels .  The air inhaled thus undergoes the oxygenation process at this level and released into the blood stream filled with oxygen.  The  lu ngs , in general,  depend on the ability of bronchial tubes to expand and contract as the normal respiratory  process continues ( Tavazzi, 2013, p. 34-39 ).

The chronic obstructive pulmonary disease  inhibit s  the elasticity of bronchial tubes and over expand . This leaves some air trapped within the  tubes  during exhalation process.   Thus bringing about difficulties in breathing.   The process is not a one-time activity but keeps on reoccurring until the system cannot accommodate anymore-trapped air in the  tubes that   cause  the adverse effects as witnessed among patients. The initial stages of the disease cannot  be easily identified  because  the body  is still in its right frame (Tavazzi, 2013, p. 58).

Methods to contain the disease

The chronic obstructive pulmonary disease has no  cure ,  but   there are measures that can be  undertaken   to  contain  the spread of the disease both at its initial stages and also in  its advanced stages.  The American Lung Association  is fully committed   to  ensuring that patients suffering from the COPD are well-taken care off. The association offers quality resources and information involving the disease where anyone interested can have access and develop the intellectual self.  Some of the  common  methods that individuals can  undertake to  contain the disease include  exercising  frequently, taking medication as prescribed by a physician, use of  oxygen  therapy and attending pulmonary  rehabilitations  (Murphy and Sethi, 2002 , p.43 ).

Monitor your COPD

The c hronic  obstructive pulmonary disease tends to grow worse over time thus it is  very important  for a COPD  patient to   monitor  the rates and level of COPD  to  contain it. It is al s o to  monitor  the reactions to various treatment drugs  in order to avoid  a fatal reaction.

Therapy  with medication

People living with COPD can use medication to relieve adverse symptoms  and prevent the disease from further progression.  COPD patients usually use medication to enable  them  to have easy breathing with less energy. The shortness of breath experienced by these patients can be  fatal  since the heart may not receive the  much-needed  air  to facilitate all the body functionalities. 

Oxygen therapy

Patients suffering from COPD always suffer from inadequate oxygen in the body thus requires a boost in  the   form  of oxygen therapy. The lungs are either blocked or damaged  thus , cannot effectively  distribute enough   oxygen   throughout  the body  effectively .   H e  supplemental  oxygen   issued increases  the levels of pure oxygen in the body so that the lungs can have enough to distribute.  Getting extra oxygen  can  regulate the body functionality into its previous normal  activities (Murphy and Sethi, 2002 , p.55 ).

Pulmonary rehabilitation

This rehabilitation program is a six  to  twelve – week  program that  is mainly aimed  at stabilizing the condition of the patients suffering from COPD. It also  include s  educational sessions and exercises for COPD patients.  The pulmonary rehabilitation is said to have a positive impact on  patients’  shortness of breath, quality of life and reduce hospitaliza tion days of patients with COPD (Polkey, 2013, p. 44).

Prevalence of the disease in the  United States

The chronic obstructive pulmonary disease has  had  an increasing  mortality rate among the United States  citizens.  The disease has gained interest as a major public health concern. The disease is currently under intense research scrutiny because of its ever-increasing prevalence.  It is ranked third  in  the United States most killer diseases.  The  United  S tates  alone is understood to have 24 million individuals with COPD with an aggregate of 54 million  globally ,  but the global analysis is most likely to be  hindered by  the absence of specialized  equipment’s  that are  normally sued to diagnose the disease  (Tavazzi, 2013, p. 61).

Figure 1:  Proportion of USA population with  Spirometric  evidence of chronic obstructive pulmonary disease, using criteria from the Global Initiative  for  Obstructive Lung Disease (GOLD) to classify subjects.

Adapted from  D. M. Mannino et al. Eur Respir J 2006;27:627-643











Figure 2

From the figure above it is quite evident that the mortality as a result of COPD has been on a steady increase over the years since the year 1999.  The male population has a higher mortality rate than female population. This can be attributed to their lifestyles as they are highly exposed to more COPD risk factors than their female counterparts are.


Although it is not easy to approximate the  costs associated  with COPD, the disease  has   a huge impact  on  the general economy including direct costs that  are incurred  including both inpatient and  outpatient.  T he  loss of productivity due to  a   large  percentage of  the   sick   workforce who dedicate much of their time to treatment, in the year 2007, the health costs that  were directed  to COPD were estimated at $24 billion and the overall cost burden including lack of  productivity  was $43 billion.  In the year 2010, the medical cost of COPD  w as  estimated to be $ 32.1 billion with prediction studies indicating that united states will incur $ 49 billion  regarding medical  costs  related to COPD (Tavazzi, 2013, p. 73).


The c hronic  obstructive pulmonary disease has no absolute  cure . T hus ,  the patients can  only relieve  or slow down the  disease  progress in the body by incorporating various treatment actions.  Patients suffering from the disease to help in their breathing and air circulation process in the body can use  various  medicines. All the treatment  medicines   are mainly aimed  at regulating breathing process and  air circulation within the body, t he medication that is prescribed  for  people living with this condition fall und er three significant categories (Pauwels, 2012, p.24) .


Patients with  the   chronic  obstructive pulmonary  condition  to reduce the inflammation that occurs in the airways to facilitate easy breathing and free circulation of air legally use steroids.


These  normal  antibiotics are  used  to treat and control bacterial infections in the respiratory  systems  in COPD patients. Antibiotics are always preferred because the immune system has already been weakened thus cannot deal even with the smallest of the infections.


These  are inhalers  designed to open up the  patient ‘ s  airways and facilitate in making breathing much eas ier for a patient (Pauwels, 2012, p.36).

Current and future  e ducational efforts

Sensitizing the  public  about the  effects the  prevalence of COPD in the  United States  is a positive in ensuring that the disease does not reach the projected rates in the future. American Lung Association has been at  the   forefront  in ensuring that American citizens  are sensibly educated   about the dangers  of COPD and some common risk factors that can  be easily avoided . The association has also placed more informational  articles   about   OCPD have  been  placed   on its official website to facilitate easy access to information by everyone who seeks to find out more about  the   chroni c  obstructive pulmonary disease (Pauwels, 2012, p.49).

Scientists and  researchers  have identified  OCPD,  as an area of  interest ,  and  a public health concern thus  is  out to find more improved medical solutions and possible ways to control and manage the disease from becoming a number one killer in the  United States .


The c hronic  obstructive pulmonary disease is becoming  more  serious   than  previously anticipated because of the increased risk factors.  The medical practitioners are therefore encouraged to sensitize the  public  to consider regular medical  checkups  because some individuals  to  not  have the initial symptoms ,  but they come to realize when the condition is critical. COPD has no cure thus it can only be regulated so  that the  disease does not progress into extreme  conditions that  may be fatal.
















Barnes, P. J., Chowdhury, B., Kharitonov, S. A., Magnussen, H., Page, C. P., Postma, D., & Saetta, M. (2012 ). Pulmonary biomarkers in chronic obstructive pulmonary disease . American journal of respiratory and critical care medicine.

Littner, M. R. (2011).  Chronic Obstructive Pulmonary Disease.  Annals of internal medicine

Murphy, T. F., & Sethi, S. (2002).  Chronic obstructive pulmonary disease . Drugs & aging.

Pauwels, R. A., Buist, A. S., Calverley, P. M., Jenkins, C. R., & Hurd, S. S. (2012).  Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease.  American journal of respiratory and critical care medicine.

Polkey, M. I., Spruit, M. A., Edwards, L. D., Watkins, M. L., Pinto-Plata, V., Vestbo, J., … & Coxson, H. O. (2013 ). Six-minute-walk test in chronic obstructive pulmonary disease: minimal clinically important difference for death or hospitalization . American journal of respiratory and critical care medicine.

Tavazzi, L., Swedberg, K., Komajda, M., Böhm, M., Borer, J. S., Lainscak, M., … & SHIFT Investigators. (2013).  Clinical profiles and outcomes in patients with chronic heart failure and chronic obstructive pulmonary disease: an efficacy and safety analysis of SHIFT study. International journal of cardiology.




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