Back to Journals » International Journal of Chronic Obstructive Pulmonary Disease » Volume 9 » Issue 1

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

Authors Aryal S, Diaz-Guzman E, Mannino DM

Received 11 July 2014

Accepted for publication 7 August 2014

Published 14 October 2014 Volume 2014:9(1) Pages 1145—1154

DOI https://doi.org/10.2147/COPD.S54476

Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 3

Editor who approved publication: Dr Richard Russell

Shambhu Aryal,1 Enrique Diaz-Guzman,2 David M Mannino3

1Division of Pulmonary, Allergy and Critical Care Medicine, Duke University, Durham, NC, 2Division of Pulmonary, Allergy and Critical Care, University of Alabama, Birmingham, AL, 3Department of Preventive Medicine and Environmental Health, University of Kentucky, Lexington, KY, 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.

Keywords: chronic obstructive lung disease, sex, smoking, comorbidity, sex bias

Creative Commons License This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.

Download Article [PDF]  View Full Text [HTML][Machine readable]

 

Other article by this author:

Fibrinogen, chronic obstructive pulmonary disease (COPD) and outcomes in two United States cohorts

Valvi D, Mannino DM, Müellerova H, Tal-Singer R

International Journal of Chronic Obstructive Pulmonary Disease 2012, 7:173-182

Published Date: 7 March 2012

Readers of this article also read:

Low bone mineral density in COPD patients with osteoporosis is related to low daily physical activity and high COPD assessment test scores

Liu WT, Kuo HP, Liao TH, Chiang LL, Chen LF, Hsu MF, Chuang HC, Lee KY, Huang CD, Ho SC

International Journal of Chronic Obstructive Pulmonary Disease 2015, 10:1737-1744

Published Date: 1 September 2015

Prevalence of chronic obstructive pulmonary disease among patients with systemic arterial hypertension without respiratory symptoms

Rabahi MF, Pereira SA, Silva Júnior JL, Rezende AP, Castro da Costa A, Corrêa KS, Conde MB

International Journal of Chronic Obstructive Pulmonary Disease 2015, 10:1525-1529

Published Date: 31 July 2015

Comorbidity in chronic obstructive pulmonary disease. Related to disease severity?

Echave-Sustaeta JM, Comeche Casanova L, Cosio BG, Soler-Cataluña JJ, Garcia-Luján R, Ribera X

International Journal of Chronic Obstructive Pulmonary Disease 2014, 9:1307-1314

Published Date: 19 November 2014

How do COPD comorbidities affect ICU outcomes?

Ongel EA, Karakurt Z, Salturk C, Takir HB, Burunsuzoglu B, Kargin F, Ekinci GH, Mocin O, Gungor G, Adiguzel N, Yilmaz A

International Journal of Chronic Obstructive Pulmonary Disease 2014, 9:1187-1196

Published Date: 17 October 2014

Adjunctive treatment with oral AKL1, a botanical nutraceutical, in chronic obstructive pulmonary disease

Brockwell C, Ampikaipakan S, Sexton DW, Price D, Freeman D, Thomas M, Ali M, Wilson AM

International Journal of Chronic Obstructive Pulmonary Disease 2014, 9:715-721

Published Date: 9 July 2014