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Women Smoked Less Than Men but Were More Severely Affected by COPD

june2019image003While women reported smoking less than men, they were found to be more severely affected by chronic obstructive pulmonary disease (COPD).

Women with COPD reported smoking fewer cigarettes than men but experienced worse symptoms, reported lower quality of life, and suffered more frequent and severe acute exacerbations because of progressive lung disorder, according to an abstract presented at the 2019 American Thoracic Society (ATS) International Conference.

“Women comprise 50 percent of the U.S. COPD population and represent a growing proportion of incident cases,” researchers said. “Risk factors for incident COPD, clinical phenotype and prognosis differ by sex.”

Researchers analyzed data from the Subpopulations and Intermediate Outcome Measures in COPD study (SPIROMICS) to examine how COPD outcomes differed by gender. Per the report, SPIROMICS was a prospective cohort study designed to identify COPD subgroups and intermediate markers of disease progression. Considering nearly half of its participants were women, and it had collected data on COPD morbidity measures and hormonal exposure history, researchers determined it was distinctively poised for their analysis.

Study investigators examined baseline data from 1,832 SPIROMICS participants with more than 20 pack years of smoking history and COPD. Markers of COPD morbidity included respiratory-specific quality of life measures (QoL) from scores from the Saint George’s Respiratory Questionnaire (SGRQ), general QoL measures from scores from the 36-Item Short Form Health Survey version two, recorded distance on a six-minute walk test, symptom scores from the modified Medical Research Council questionnaire (mMRC) and COPD Assessment Test (CAT), and both the frequency and severity of acute exacerbations.

Frequent acute exacerbations were defined as two or more suffered per year. Researchers considered an exacerbation to be severe if it resulted in hospitalization or an emergency room visit.

Approximately 42 percent (781) of individuals included in the analysis were women. Age, race, smoking status and predicted forced expiratory volume were similar between women and men. The mean number of reported smoking pack-years was 48 for females and 56 for males.

Researchers found that females were independently associated with:

  • Greater respiratory impairment
  • greater general impairment, and
  • shorter distances walked.

Researchers also found that women had higher chances of hypoxemia and were more likely to be symptomatic. They also experienced a greater frequency of acute exacerbations and more severe acute exacerbations than men.

Click here to read the full article in AJMC.