Associations of chronic obstructive pulmonary disease with all-cause mortality in Blacks and Whites: the atherosclerosis risk in communities (ARIC) study.

OBJECTIVE

To determine the burden of chronic obstructive pulmonary disease (COPD) on all-cause mortality in Blacks and Whites from four US communities.

METHODS

We determined prospectively the risk of death through December 2004 in relation to baseline (1987-1989) COPD status in 10,333 Black and White participants of the Atherosclerosis Risk in Communities (ARIC) study.

RESULTS

Over a mean follow-up of 15 years (maximum 18 years), 462 deaths occurred in Blacks and 1221 deaths occurred in Whites. Hazard ratios for all-cause mortality among Blacks and Whites were similar (hazard ratio [HR] = 1.74 in Blacks and HR = 1.59 in Whites), indicating a 59%-74% greater risk of mortality for those with COPD. However, for both those with and without COPD, crude death rates were approximately double in Blacks compared to Whites.

CONCLUSIONS

Our findings suggest that given COPD, Blacks and Whites have the same proportionate increase in mortality and that the difference in death rates between Blacks and Whites cannot be explained by COPD status. The public health burden of COPD is enormous, and strategies to reduce COPD and smoking could have a large impact on total mortality rates of both Blacks and Whites.