Study identifies key risk factors for early COPD among US Hispanic/Latinos

Chronic obstructive pulmonary disease (COPD) is a progressive disorder that is often not diagnosed until a patient is over 60 years old and has substantial airflow obstruction. At this stage, it can be difficult to manage and treat the condition. To identify those at risk and intervene earlier, several studies have examined risk factors for COPD. But studies to date have predominantly focused on white and older populations. A new study led by investigators from Brigham and Women's Hospital leveraged data from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) to examine risk factors for early COPD among U.S. Hispanics/Latinos and identified asthma as one of the most important risk factors, followed by smoking and chronic sinusitis. Results are published in Annals of the American Thoracic Society.

"Hispanics/Latinos are the largest and youngest minority in the U.S., making up 18 percent of the population in 2018," said corresponding author Alejandro Diaz, MD, MPH, of the Division of Pulmonary and Critical Care Medicine at the Brigham. "Nevertheless, prevalence and risk factors for early COPD among this population have not been identified, so we set out to do just that in this understudied population."

Diaz and colleagues used data from the HCHS/SOL, a population-based study of four U.S. communities that enrolled self-identified Hispanic/Latino men and women aged 18-74 from randomly selected households. For their analysis, the investigators focused on participants between the ages of 18 and 49 who had completed a respiratory questionnaire and spirometry—a measure of the speed at which a person can inhale and exhale air. These measurements were used to calculate early COPD.

The researchers found that 524 respondents met the criteria for early COPD. After using a model to adjust for variables, the team found that asthma, past smoking history and chronic sinusitis were significantly associated with increased odds of early COPD. The prevalence of early COPD among the population studied was 7.6 percent. This rate was consistent across age groups studied.

"This suggests that younger Hispanics/Latinos seem to be similarly susceptible to the disease and supports the notion for the need to comprehensibly understand the disease in younger people," said Diaz.

The team notes that the associations it uncovered merit further investigation, including the relationship between chronic sinusitis and COPD. The two conditions share symptoms, including coughing and sputum production, but further study is needed to understand the connection. Smoking was also found to be a risk factor for early COPD, despite the fact that U.S. Hispanics/Latinos, on average, have lower smoking rates and smoke fewer packs of cigarettes than other U.S. populations.

Diaz notes that a critical public health measure to reduce early COPD risk is smoking cessation/tobacco treatment (including vaped and other non-burnt tobacco products).

"Efforts to increase awareness and access to treatment programs are critical," he said. "These efforts include culturally sensitive and bilingual programs about education, counseling, and therapies for tobacco treatment. Also, measures to reduce exposure to respiratory hazards at work—such as use of masks and avoidance of irritating cleaning products—are essential in this population."