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Influence of sex on chronic obstructive pulmonary disease risk and treatment outcomes.

Aryal S, Diaz-Guzman E, Mannino DM - Int J Chron Obstruct Pulmon Dis (2014)

Bottom Line: This has largely been attributed to historical increases in tobacco consumption among women.In addition, women with COPD are more likely to have a chronic bronchitis phenotype, suffer from less cardiovascular comorbidity, have more concomitant depression and osteoporosis, and have a better outcome with acute exacerbations.There are also differences in how men and women respond to different therapies.

View Article: PubMed Central - PubMed

Affiliation: Division of Pulmonary, Allergy and Critical Care Medicine, Duke University, Durham, NC, USA.

ABSTRACT
Chronic obstructive pulmonary disease (COPD), one of the most common chronic diseases and a leading cause of death, has historically been considered a disease of men. However, there has been a rapid increase in the prevalence, morbidity, and mortality of COPD in women over the last two decades. This has largely been attributed to historical increases in tobacco consumption among women. But the influence of sex on COPD is complex and involves several other factors, including differential susceptibility to the effects of tobacco, anatomic, hormonal, and behavioral differences, and differential response to therapy. Interestingly, nonsmokers with COPD are more likely to be women. In addition, women with COPD are more likely to have a chronic bronchitis phenotype, suffer from less cardiovascular comorbidity, have more concomitant depression and osteoporosis, and have a better outcome with acute exacerbations. Women historically have had lower mortality with COPD, but this is changing as well. There are also differences in how men and women respond to different therapies. Despite the changing face of COPD, care providers continue to harbor a sex bias, leading to underdiagnosis and delayed diagnosis of COPD in women. In this review, we present the current knowledge on the influence of sex on COPD risk factors, epidemiology, diagnosis, comorbidities, treatment, and outcomes, and how this knowledge may be applied to improve clinical practices and advance research.

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Prevalence of self-reported chronic obstructive pulmonary disease among adults aged 18 and over: US, 1998–2009.Note: Data from Akinbami LJ, Liu X. Chronic obstructive pulmonary disease among adults aged 18 and over in the United States, 1998–2009. 2011. Available from: http://www.cdc.gov/nchs/data/databriefs/db63.htm.25
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f1-copd-9-1145: Prevalence of self-reported chronic obstructive pulmonary disease among adults aged 18 and over: US, 1998–2009.Note: Data from Akinbami LJ, Liu X. Chronic obstructive pulmonary disease among adults aged 18 and over in the United States, 1998–2009. 2011. Available from: http://www.cdc.gov/nchs/data/databriefs/db63.htm.25

Mentions: In the US, between the first and third National Health and Nutrition Examination Surveys (NHANES), the prevalence of spirometrically determined COPD increased among women from 50.8 to 58.2 per 1,000, while the prevalence decreased among men from 108.1 to 74.3 per 1,000.24 Findings from the National Health Interview Survey (NHIS) show that the self-reported prevalence of COPD (chronic bronchitis and emphysema) in the US did not change between 1998 and 2009, and has remained higher among women than among men (Figure 1).25 Similar patterns have been observed in other developed countries like Canada, Netherlands, and Austria.26–28 In the developing world, diagnosed COPD remains higher among men than among women;29–31 while some of these differences may reflect a sex bias in the diagnosis of COPD, the future will likely see increasing prevalence among women as more take up smoking and work in traditionally male occupations.32


Influence of sex on chronic obstructive pulmonary disease risk and treatment outcomes.

Aryal S, Diaz-Guzman E, Mannino DM - Int J Chron Obstruct Pulmon Dis (2014)

Prevalence of self-reported chronic obstructive pulmonary disease among adults aged 18 and over: US, 1998–2009.Note: Data from Akinbami LJ, Liu X. Chronic obstructive pulmonary disease among adults aged 18 and over in the United States, 1998–2009. 2011. Available from: http://www.cdc.gov/nchs/data/databriefs/db63.htm.25
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4206206&req=5

f1-copd-9-1145: Prevalence of self-reported chronic obstructive pulmonary disease among adults aged 18 and over: US, 1998–2009.Note: Data from Akinbami LJ, Liu X. Chronic obstructive pulmonary disease among adults aged 18 and over in the United States, 1998–2009. 2011. Available from: http://www.cdc.gov/nchs/data/databriefs/db63.htm.25
Mentions: In the US, between the first and third National Health and Nutrition Examination Surveys (NHANES), the prevalence of spirometrically determined COPD increased among women from 50.8 to 58.2 per 1,000, while the prevalence decreased among men from 108.1 to 74.3 per 1,000.24 Findings from the National Health Interview Survey (NHIS) show that the self-reported prevalence of COPD (chronic bronchitis and emphysema) in the US did not change between 1998 and 2009, and has remained higher among women than among men (Figure 1).25 Similar patterns have been observed in other developed countries like Canada, Netherlands, and Austria.26–28 In the developing world, diagnosed COPD remains higher among men than among women;29–31 while some of these differences may reflect a sex bias in the diagnosis of COPD, the future will likely see increasing prevalence among women as more take up smoking and work in traditionally male occupations.32

Bottom Line: This has largely been attributed to historical increases in tobacco consumption among women.In addition, women with COPD are more likely to have a chronic bronchitis phenotype, suffer from less cardiovascular comorbidity, have more concomitant depression and osteoporosis, and have a better outcome with acute exacerbations.There are also differences in how men and women respond to different therapies.

View Article: PubMed Central - PubMed

Affiliation: Division of Pulmonary, Allergy and Critical Care Medicine, Duke University, Durham, NC, USA.

ABSTRACT
Chronic obstructive pulmonary disease (COPD), one of the most common chronic diseases and a leading cause of death, has historically been considered a disease of men. However, there has been a rapid increase in the prevalence, morbidity, and mortality of COPD in women over the last two decades. This has largely been attributed to historical increases in tobacco consumption among women. But the influence of sex on COPD is complex and involves several other factors, including differential susceptibility to the effects of tobacco, anatomic, hormonal, and behavioral differences, and differential response to therapy. Interestingly, nonsmokers with COPD are more likely to be women. In addition, women with COPD are more likely to have a chronic bronchitis phenotype, suffer from less cardiovascular comorbidity, have more concomitant depression and osteoporosis, and have a better outcome with acute exacerbations. Women historically have had lower mortality with COPD, but this is changing as well. There are also differences in how men and women respond to different therapies. Despite the changing face of COPD, care providers continue to harbor a sex bias, leading to underdiagnosis and delayed diagnosis of COPD in women. In this review, we present the current knowledge on the influence of sex on COPD risk factors, epidemiology, diagnosis, comorbidities, treatment, and outcomes, and how this knowledge may be applied to improve clinical practices and advance research.

Show MeSH
Related in: MedlinePlus