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Article
Influence of Sex on Chronic Obstructive Pulmonary Disease Risk and Treatment Outcomes
International Journal of Chronic Obstructive Pulmonary Disease
  • Shambhu Aryal, Duke University
  • Enrique Diaz-Guzman, University of Alabama, Birmingham
  • David M. Mannino, University of Kentucky
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.
Document Type
Review
Publication Date
10-1-2014
Notes/Citation Information

Published in International Journal of Chronic Obstructive Pulmonary Disease, v. 9, issue 1, p. 1145-1154.

This work is published by Dove Medical Press Limited, and licensed under Creative Commons Attribution - Non Commercial (unported, v3.0) License. The full terms of the License are available at http://creativecommons.org/licenses/by-nc/3.0/. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. Permissions beyond the scope of the License are administered by Dove Medical Press Limited. Information on how to request permission may be found at: http://www.dovepress.com/permissions.php

Digital Object Identifier (DOI)
http://dx.doi.org/10.2147/COPD.S54476
Citation Information
Shambhu Aryal, Enrique Diaz-Guzman and David M. Mannino. "Influence of Sex on Chronic Obstructive Pulmonary Disease Risk and Treatment Outcomes" International Journal of Chronic Obstructive Pulmonary Disease Vol. 9 Iss. 1 (2014) p. 1145 - 1154
Available at: http://works.bepress.com/david_mannino/254/