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The management of chronic obstructive pulmonary disease
Chronic obstructive pulmonary disease (COPD) is the fourth most common cause of mortality worldwide and is predicted to become more of a problem over the next 20 years. The predominant cause of COPD in high-income countries is cigarette smoking, whereas the major cause in low-income countries remains the use of biomass fuel for cooking and heating. A great deal of COPD remains undiagnosed and the greater use of spirometry in screening would identify patients who could be helped by treatment. The aim of treatment is to reduce further problems by stopping exposure to harmful agents and by reducing exacerbations. Many treatments are available to improve symptoms and to treat exacerbations and a simple classification based on lung function and symptoms can be used to guide the general approach to treatment.