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More than 40 Percent of Women with Asthma May Develop COPD
More than four in 10 women with asthma may eventually develop chronic obstructive pulmonary disease (COPD), according to a study conducted in Ontario, Canada, and published online in the Annals of the American Thoracic Society.
In “Asthma and COPD Overlap in Women: Incidence and Risk Factors,” Teresa To, PhD, and co-authors report that of the 4,051 women with asthma included in their study, 1,701 -- or 42 percent -- developed COPD. The woman of the study were followed for 14 years after being diagnosed with asthma, researchers examining risk factors for developing asthma and COPD overlap syndrome, known as ACOS. Those who developed ACOS experience increased exacerbations and hospitalizations and, thus, had a lower quality of life compared to those who have asthma or COPD alone.
The authors also reported that individual risk factors played a more significant role in the development of ACOS than exposure to fine particulate matter, a major air pollutant that because of its microscopic size penetrates deep into the lungs. Also, those women who had a more than five-pack-year smoking history, meaning they had smoked more than the equivalent of a pack of cigarettes a day for five years, were much more likely to develop ACOS than those who smoked fewer cigarettes or never smoked.
Smoking was not the only reason for the development of ACOS, however. Thirty-eight percent of the women who developed ACOS in the study had never smoked.
In addition to smoking, the study identified obesity, rural residence, lower education levels and unemployment as significant risk factors for ACOS. The authors speculated that these factors indicative of low socioeconomic status may result in suboptimal access to care, under-treatment of asthma and poor compliance to medications.
These factors can lead to more frequent attacks of asthma, which can lead to “airway remodeling” that increases the chances of developing ACOS.
“Previous studies have found an alarming rise in ACOS in women in recent years and that the mortality rate from ACOS was higher in women than men,” said Dr. To, a professor in the Graduate School of Public Health at the University of Toronto in Canada. “We urgently need to identify and quantify risk factors associated with ACOS in women to improve their health and save lives.”
The authors of the study said that are “encouraged by the fact that most of the risk factors identified” can be modified.
“The adverse impact of smoking and obesity on health may be even worse in those who are already living with asthma or COPD," said Dr. To. “Identifying modifiable risk factors in the progression from asthma to COPD is an essential first step in developing prevention strategies that lead to a healthy, active lifestyle.”
