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Georges Respiratory Questionnaire (SGRQ) was used to capture health-related quality of life.14 Dyspnea was measured using the modified Medical Research Council (mMRC) score.15 Chronic bronchitis was defined as the presence of chronic cough and phlegm production for at least 3 months per year for 2 or more consecutive years.16 Volumetric computerized tomography (CT) scans were acquired in both cohorts (see Supplemental Appendix for further clinical phenotyping details)

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[19] : 11 In 1959, Time fired him for insubordination

Blood pressure spikes acutely