Study Results Call for Attention to Sex Differences in COPD

Clinical characteristics of women with chronic obstructive pulmonary disease (COPD) are important for primary care clinicians to consider in order to improve COPD awareness since women often go underdiagnosed, according to results from a recent study.

The research, published in the International Journal of Chronic Obstructive Pulmonary Disease, involved a cross-sectional multicenter study that aimed at identifying the clinical characteristics of women with COPD who attended a routine daily practice in Spain in order to explore the sex differences in COPD patients.

“Although for many years COPD affected men in a higher proportion than women, the prevalence has equalized by now. However, there remains an outdated perception of COPD as a male-dominated disease combined with a lack of awareness of symptoms among women. The prevalence and mortality of COPD in women have more than doubled during the past 20 years in industrialized countries while they stabilized in men,” explained the authors. “Different studies have shown a sex effect, with an increase in COPD mortality among women.”

The researchers collected the patients’ data including age, sex, body mass index, smoking status, duration of COPD, and comorbid conditions. Of the 1610 consecutive patients diagnosed with COPD who were recruited in primary care centers and pneumology services throughout Spain over a 90-day period, 17.9% were women, according to the researchers. Furthermore, males demonstrated a higher prevalence of nonexacerbator and exacerbator with chronic bronchitis phenotypes compared with females. However, the asthma-COPD overlap syndrome (ACOS) was more common among females, noted the study.

The results further demonstrated that sex-related differences in regards to smoking status were significant, with a higher percentage of men as compared with women in the groups of current smokers and ex-smokers. However, never-smokers were higher in women (9.1%) than in men, (0.6%). Additionally, the study found that the average number of comorbidities was 2.01 in males and 1.99 in females, cardiovascular diseases were more frequent in men, and metabolic disorders were more frequent in women.

“This study provides evidence of the clinical characteristics of women with COPD attended in the primary and specialized care in routine daily practice in Spain and is important for primary care clinicians in order to improve COPD awareness in women in which underdiagnosis is very common. Differences in the prevalence rates of COPD phenotypes between men and women have been documented, with ACOS particularly frequent in female patients,” noted the authors. “Lung function impairment, COPD severity, and impact of COPD on the patient’s quality of life were apparently similar in men and women.”

The study suggests that these results demonstrate the impact of COPD in women and the importance of further sex-based research in tobacco-related respiratory diseases.

Reference

Trigueros J, Riesco J, et al. Clinical features of women with COPD: sex differences in a cross-sectional study In spain [published online November 5, 2019]. Int J Chron Obstruct Pulmon Dis. doi.org/10.2147/COPD.S217921.