Chronic obstructive pulmonary disease at the primary–secondary care interface

In primary care, the diagnosis is usually not made until symptoms are well established with patients usually being over the age of 50 years. With increasing age the prevalence rises to approximately 5 per cent of men aged 65-74 years and 10 per cent of men older than 75 years. Historically, more men have been affected but women are rapidly catching up. The COPD prevalence figures from Denmark, where women have smoked for longer than men show prevalence now equal. It is the fifth commonest cause of death in the UK, affecting 7.4 per cent of male and 4.1 per cent of female deaths, and is a contributory factor on a further 4 per cent of death certificates.