ABSTRACT

Chronic obstructive pulmonary disease is a major public health problem caused by long-term exposure to toxic gases and particules. Recent publications continue to use the basic criterion of FEV1/FVC <70% in defining the bronchial obstruction in guidelines of the Global Inintiative for Chronic Obstructive Lung Disease (GOLD). Unfortunately, using this fixed ratio in the diagnosis of chronic obstructive pulmonary disease may lead to misdiagnosis in the elderly since FEV1/FVC ratio declines with age. There is an increase in the frequency and nature of comorbidities such as coronary artery disease, hypertention, diabetes, pulmonary infections and cancer in patients with chronic obstructive pulmonary disease. Prevention of disease progression, improvement of symptoms, exercise tolerance, health status, and decrease in exacerbations and mortality are the main goals in the management of chronic obstructive pulmonary disease. Several novel bronchodilators are now in different stages of development for use alone or in combination with other agents.