Gender and chronic obstructive pulmonary disease: Why it matters

Mei Lan K. Han, Dirkje Postma, David M. Mannino, Nicholas D. Giardino, Sonia Buist, Jeffrey L. Curtis, Fernando J. Martinez

Research output: Contribution to journalReview article

205 Scopus citations

Abstract

The prevalence of chronic obstructive pulmonary disease (COPD) in women is increasing, as is hospitalization for COPD. The number of women dying of COPD in the United States now surpasses men. Despite this, research suggests that physicians are still more likely to correctly diagnose men with COPD than women. Increased tobacco use in women likely explains some of the increase in the prevalence of COPD in women, but data suggest that women may actually be at greater risk of smoking-induced lung function impairment, more severe dyspnea, and poorer health status for the same level of tobacco exposure. The degree to which these observations represent biologic, physiologic, or sociologic differences is not known. Nonsmokers with COPD are also more likely to be female. In addition, new evidence is emerging that men and women may be phenotypically different in their response to tobacco smoke, with men being more prone to an emphysematous phenotype and women an airway predominant phenotype. Inasmuch as COPD is a disease of inflammation, it is also possible that sexual dimorphism of the human immune response may also be responsible for gender differences in the disease. More data are still needed on what the implications of these findings are on therapy. In this clinical commentary, we present current knowledge regarding how gender influences the epidemiology, diagnosis, and presentation of COPD in addition to physiologic and psychologic impairments and we attempt to offer insight into why these differences might exist and how this may influence therapeutic management.

Original languageEnglish (US)
Pages (from-to)1179-1184
Number of pages6
JournalAmerican journal of respiratory and critical care medicine
Volume176
Issue number12
DOIs
StatePublished - Dec 15 2007

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Keywords

  • Obstructive lung disease
  • Sex
  • Smoking
  • Tobacco susceptibility

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine

Cite this

Han, M. L. K., Postma, D., Mannino, D. M., Giardino, N. D., Buist, S., Curtis, J. L., & Martinez, F. J. (2007). Gender and chronic obstructive pulmonary disease: Why it matters. American journal of respiratory and critical care medicine, 176(12), 1179-1184. https://doi.org/10.1164/rccm.200704-553CC