Coughing and Short of Breath? Is it COPD?

By Antonello Punturieri, M.D., PhD | Published 2/19/2019 1

Carrying out a description of the radiographs of a patient with

Photo Source: Adobe Stock Photoes

One of the leading causes of death in the United States, chronic obstructive pulmonary disease, or COPD, affects millions of Americans.

Known also as chronic bronchitis or emphysema, many mistake COPD’s slowly oncoming, but steadily-worsening signs and symptoms – shortness of breath, chronic coughing, and wheezing – as problems that naturally come with aging or being out of shape.

This can often lead to a delay in seeking medical treatment and therefore getting diagnosed. If left undetected, this devastating lung disease can greatly impact one’s quality of life and ability to complete everyday tasks.

Thankfully, the disease is treatable.

Misconceptions about COPD

COPD affects people across the country. However, there are misconceptions about,

  • how many people actually have the disease,
  • who is most at risk, and
  • where they live.

COPD is greatly underdiagnosed.

While about 16 million people have been diagnosed, we estimate that several million more have the disease without knowing it.

-COPD has been mislabeled as a “man’s disease.”

Yet 56 percent of patients with the disease are women.

-Misconceptions about where patients live

Data released in CDC’s Morbidity and Mortality Weekly Report (MMWR) show that the percentage of adults in rural areas who have been diagnosed with COPD is nearly double the percentage in large urban areas, according to 

Cigarette smoking is the main risk factor for COPD.

So, what’s behind these dire numbers? For the most part, it is cigarette smoking.

Smoking is the main risk factor for and cause of COPD. But the story is not as simple as that, as up to 25 percent of people with COPD have never smoked.

Long-term exposure to other lung irritants—such as air pollution, chemical fumes, or dusts—also may contribute to COPD. A rare genetic condition called alpha-1 anti-trypsin (AAT) deficiency can also cause the disease.

The cost of COPD 

Whatever the reason a person gets the disease, the impact on society is profound. And it continues to grow.

In 2010, Americans spent more than $32 billion on COPD-related patient care. Those costs are projected to increase to $49 billion by 2020. Most costs are associated with hospital care.

In the next five years, hospitalizations for COPD will exceed those for heart disease.  

Currently, heart disease is the number one reason people are hospitalized. Compounding the economic problem is COPD’s grave impact on work: more than half of COPD patients report that their disease hinders their ability to do their jobs.  

Communication Matters

Given the serious, often deadly, consequences of the disease, why do so many Americans go undiagnosed? Qualitative research points to a communications gap between patients and their health care providers.[1]

While one in 10 adults experience signs or symptoms of COPD, only seven in 10 of these adults report talking to their health care provider about their signs or symptoms. Primary care providers believe that a major barrier to diagnosis is patients not fully reporting their symptoms during visits.

This communications barrier on both sides of the patient and health care provider relationship remains a challenge for diagnosing and treating patients with COPD.

The most important way to get care to those who need it is to encourage patients and health care providers to speak frankly with each other. That way a patient’s history of exposure to lung irritants and his or her disease symptoms can come to light—and a plan of care prescribed.

How else can we help ease the burden of the disease?

Consider these three critical steps:

1. Prevent COPD before it starts.

The best way to do this is to avoid tobacco smoke or to quit smoking.

If you smoke, talk with your health care provider about what to do to help you quit. A variety of medications on the market can bolster your efforts. In addition, joining a support group can keep you motivated.

Also, try to avoid lung irritants that can contribute to COPD, such as air pollution, chemical fumes, dust, and secondhand smoke. Ask your family members and friends to support you in your efforts to be lung health conscious.

2. If you already have COPD, prevent complications and slow the progression 

Avoid exposure to the lung irritants mentioned above and follow the treatment plan your health care provider prescribes.

Providers can

  • help you breathe easier,
  • stay more active, and
  • avoid or manage exacerbations (a sudden worsening of symptoms).

Stay up-to-date on vaccinations. People at risk for or with COPD should do as much as they can to protect themselves against influenza (the flu) and pneumonia. These vaccines can lower the chances of getting these illnesses, which are major health risks for people who have COPD

3. Consider pulmonary rehabilitation if standard treatments are not enough.

Research data show positive outcomes from pulmonary rehabilitation, which may help certain people with COPD live and breathe better.

Also known as respiratory rehabilitation, pulmonary rehabilitation is an exercise and support program for people with a chronic respiratory disease who remain symptomatic or continue to have decreased function despite standard medical treatment.

An important part of the management of the disease, it is most effective when started in the moderate stage of COPD. But even people who have advanced stage lung disease can benefit as it helps reduce overall symptoms, increase physical activity, improve daily life function, and improves psychological health.

Related Article:  At Home Noninvasive Ventilation for COPD Saves Time & Money

These recommendations focus on what people living with and at risk for COPD can do to improve their health.   

We at the National Heart, Lung, and Blood Institute (NHLBI) are committed to helping everybody across the country understand COPD and become aware of what is at stake.

COPD National Action Plan

In 2017, we worked with federal and non-federal partners across the country to release the first COPD National Action Plan, which provides a framework for unified action by all Americans to reduce the burden of the disease.

The plan is built on five distinct goals that address the needs of the entire community including:

  • people at risk for COPD
  • people who live with the disease
  • caregivers
  • health care providers
  • advocacy groups
  • researchers
  • payers and health systems
  • policymakers

Want to join us in our efforts? Through the COPD Learn More Breathe Better® program, NHLBI offers a variety of educational resources to help increase awareness and understanding about COPD among patients, their families and caregivers, and health care providers.   

  Together, we can all work to help people
with COPD breathe better.



  1. COPD: Tracking Perceptions of the Individuals Affected and the Providers Who Treat Them2018 Report. National Heart, Lung, and Blood Institute. Available at:

[Author]: Statements provided in this blog are for informational purposes only and do not constitute medical advice or recommendations.


Antonello Punturieri, M.D., PhD


Antonello (Tony) Punturieri, Ph.D., M.D., is a Program Officer in the Division of Lung Diseases (DLD), NHLBI, NIH. In this capacity, Dr. Punturieri administers a varied portfolio of grants and contracts in the area of COPD and environment. Specifically, Dr. Punturieri participates in the development and administration of programs that aim at the understanding of COPD disease mechanisms, COPD prevention, and the testing and evaluation of COPD therapies. Dr. Punturieri obtained a M.D. from the Medical School at University of Ferrara (Italy) and a Ph.D. in Immunology from La Sapienza University in Rome, Italy. He spent four years at NIH as Visiting Fellow at NIDDK and Visiting Associate at NIAID. He returned to Rome as Assistant Professor of Pathophysiology at La Sapienza University in Rome (Italy) while also working as Staff Scientist at Regina Elena Cancer Institute. He then moved to the Division of Hematology/Oncology at the University of Michigan, Ann Arbor, MI, and subsequently joined the Pulmonary Division at Michigan and the Veterans Administration Hospital (Pulmonary Section) in Ann Arbor. He joined NHLBI in 2006.


  • i have been effected by extra plumenary TB but now i have get my health back by using traditional medications.

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