Asthma ‘one of the most important risk factors’ for early COPD in Hispanics/Latinos in US

Asthma, history of smoking and chronic sinusitis are risk factors for early COPD in U.S. Hispanic/Latino individuals aged younger than 50 years, researchers reported in Annals of the American Thoracic Society.

“Among U.S. Hispanics/Latinos, asthma is one of the most important risk factors for early COPD, followed by smoking and chronic sinusitis,” Alejandro A. Diaz, MD, MPH, from the division of pulmonary and critical care medicine at Brigham and Women’s Hospital and Harvard Medical School, told Healio.

Researchers evaluated baseline data from 16,415 individuals who were of Hispanic/Latino ethnicity from the Hispanic Community Health Study/Study of Latinos and identified 7,323 participants younger than 50 years. Researchers then identified risk factors in this patient population and estimated the prevalence of early COPD. Early COPD was defined as FEV₁/FVC ratio less than the lower limit of normal.

“We were interested in studying early COPD because understanding this process at earlier ages can help to identify ways to halt it. Also, COPD is understudied in U.S. Hispanics/Latinos, despite having an 18% share of the U.S. population,” Diaz told Healio. “Hispanics/Latinos, on average, have lower tobacco smoking rates than whites, making this factor interesting to explore in early COPD in this ethnicity.”

Overall, 524 participants met criteria for early COPD. The sex- and age-adjusted prevalence of early COPD was 7.6%.

Asthma (OR = 3.37; 95% CI, 2.57-4.41), ever smoking (OR = 1.65; 95% CI, 1.24-2.2) and chronic sinusitis (OR = 1.71; 95% CI, 1.09-2.66) were risk factors associated with increased odds of early COPD.

Compared with U.S.-born Hispanic/Latino individuals, Hispanic/Latino immigrants had lower odds of early COPD among those younger than 15 years at immigration who lived in the U.S. for less than 10 years (OR = 0.94; 95% CI, 0.39-2.27), those younger than 15 years at immigration who lived in the U.S. for 10 years or more (OR = 0.55; 95% CI, 0.37-0.84), those aged 15 years and older at immigration who lived in the U.S. for less than 10 years (OR = 0.86; 95% CI, 0.57-1.3) and those aged 15 years and older at immigration who lived in the U.S. for 10 years or more (OR = 0.63; 95% CI, 0.42-0.95).

In addition, pack-years of smoking was not associated with early COPD among smokers for 5 to 9.9 pack-years vs. less than 5 pack-years (OR = 1.04; 95% CI, 0.59-1.82) and 10 or more pack-years vs. less than 5 pack-years (OR = 1.2; 95% CI, 0.74-1.94).

The mean population attributable risk for asthma was 26.3%, for smoking was 22.4% and for chronic sinusitis was 6.9%.

“We need more studies to understand the impact of early COPD in people, such as quality of life, exercise and health care use. We also need studies to uncover why some smokers develop the disease while others are susceptible,” Diaz said. “Finally, we need to find preventive and therapeutic interventions at an early age to alleviate people suffering from this condition.”

For more information:

Alejandro A. Diaz, MD, MPH, can be reached at adiaz6@bwh.harvard.edu.