Gender and Chronic Obstructive Pulmonary Disease in High-Risk Smokers

de-Torres, Juan P.; Campo, Arantza; Casanova, Ciro; Aguirre‐Jaime, Armando; Zulueta, Javier J.

doi:10.1159/000090051

Cited by 39 publications

(27 citation statements)

References 36 publications

(19 reference statements)

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“…In Europe, the prevalence of COPD ranges between 13% (UK) and 46% (Belgium, Poland). [24][25][26][27][28] However, recent studies show that even after elimination of the known influencing factors, considerable national differences in prevalence remain unexplained and should be the subject of further investigations. 18 Symptoms of cough, sputum production and dyspnoea were distributed fairly evenly across our study population, independent of the presence and severity of airflow limitation, and asymptomatic subjects were as equally likely to present with airflow limitation as symptomatic ones.…”

Section: Discussionmentioning

confidence: 99%

Patient-reported respiratory symptoms and pre-bronchodilator airflow limitation among smokers in Switzerland

Malka

Linz

Praehauser

et al. 2010

Primary Care Respiratory Journal

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Aims: To evaluate the prevalence and predictors of airflow limitation among smokers aged >40 years visiting primary care practices in Switzerland, and the correlation between airflow limitation and patient-reported symptoms.Methods: General practitioners (GPs) were invited to participate in the study via letter. Airflow limitation was measured using an EasyOne™ spirometer without administration of a bronchodilator, and patient-reported symptoms were evaluated using an intervieweradministered questionnaire.Results: 15,084 subjects recruited by 440 GPs had acceptable quality spirometry traces; 8,031 of these (53%) had symptom data available and were included in this analysis. Only 18.5% of the GP consultations were for respiratory reasons. In total, 29% of individuals had prebronchodilator airflow limitation suggesting chronic obstructive pulmonary disease according to the Global Initiative for Chronic Obstructive Lung Disease (GOLD)/Hardie interpretation. The interviewer-administered questionnaire indicated that 58% of individuals had at least one current symptom -cough, sputum production, or dyspnoea. There were no differences in lung function for patients answering yes or no to symptom questions.Conclusions: Pre-bronchodilator airflow limitation and patient-reported respiratory symptoms are frequent among smokers, but short dichotomous questions about symptoms are not useful for identifying patients with airflow limitation. Spirometry can identify patients with early airflow limitation in general practice. However, poor quality of spirometry, even with an automated feedback and quality control spirometer, remains an issue.

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Section: Discussionmentioning

confidence: 99%

Patient-reported respiratory symptoms and pre-bronchodilator airflow limitation among smokers in Switzerland

Malka

Linz

Praehauser

et al. 2010

Primary Care Respiratory Journal

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“…In the current study, male nonsmokers were more likely to have COPD than female nonsmokers, probably a result of higher exposure to risk factors. While current evidence suggests differential risks for females and males for COPD in different communities (which may be attributed to different exposure to risk factors), the difference in COPD susceptibility between the sexes remains controversial [37,38]. Nevertheless, the real reasons are expected to be clarified in the near future.…”

Section: Copd In Chinese Nonsmokers Y Zhou Et Almentioning

confidence: 99%

COPD in Chinese nonsmokers

Zhou¹,

Yao²,

Chen³

et al. 2009

European Respiratory Journal

140

109

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Little is known about chronic obstructive pulmonary disease (COPD) in Chinese nonsmokers. The present study aimed to investigate the profiles of COPD among nonsmokers based on the Chinese Epidemiological Survey of COPD (CESCOPD).In the CESCOPD, 20,245 subjects aged 40 yrs or older were interviewed with questionnaires and spirometry tests. Subjects with a post-bronchodilator forced expiratory volume in one second (FEV1)/forced vital capacity (FVC) ratio of ,0.70 were identified as having COPD. Data of 12,471 nonsmokers and 1,024 smoking COPD patients were analysed in the current study.The overall prevalence of COPD among nonsmokers was 5.2% (95% confidence interval 4.8-5.6). Being male, of advanced age, lower body mass index (BMI) and lower educational level, having exposure to environmental tobacco smoke, coal and/or biomass smoke, poor ventilation in the kitchen, a family history of respiratory disease and recurrent childhood cough were all independently associated with a higher risk of having COPD among nonsmokers. Nonsmokers with respiratory symptoms without airflow limitation showed a somewhat different pattern of risk factors. Nonsmokers with COPD were less likely to present with chronic productive coughs and lower BMI, while more likely to have received a physician diagnosis of asthma and respiratory diseases in childhood, than smokers with COPD.Chronic obstructive pulmonary disease is prevalent among Chinese nonsmokers, and nonsmoking chronic obstructive pulmonary disease may have different profiles from smoking chronic obstructive pulmonary disease.

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“…However, in this study, persons with a positive bronchodilator response were excluded. 52 A 25-year follow-up study of the general population in Copenhagen showed no difference in COPD prevalence between men and women; however, the authors noted that classification of smoking history was not detailed. Because men smoked more tobacco daily than women at that time in Denmark, a higher susceptibility of women to COPD per gram of tobacco may have been masked.…”

Section: Susceptibilitymentioning

confidence: 99%

Reconsidering sex-based stereotypes of COPD

Ohar

Fromer

Donohue

2011

Primary Care Respiratory Journal

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Chronic obstructive pulmonary disease (COPD) has historically been considered a disease of older, white, male smokers, as illustrated in Frank Netter's classic images of the 'pink puffer' and 'blue bloater'. However, women may be more susceptible to COPD than men, and the disease course may be reflective of that increased susceptibility. From a review of epidemiological data of COPD, we found differences in the way men and women present with COPD symptoms, a bias in the way COPD symptoms are treated in men and women, and differences in susceptibility to airway obstruction based on age, sex, and smoking history. These data show that classic stereotypes of COPD -including male predominance -should be abandoned, and that there are not two but multiple COPD phenotypes, which are characterised by differences between women and men in susceptibility, symptoms, and disease progression. These differences impact on physician perception. Although further research into this concept is needed, the differences we found should prompt, in the short term, changes in the way (and in whom) COPD is evaluated, diagnosed, and treated; in the long term, these differences should prompt research into the prognosis of COPD based on sex differences.

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Gender and Chronic Obstructive Pulmonary Disease in High-Risk Smokers

Cited by 39 publications

References 36 publications

Patient-reported respiratory symptoms and pre-bronchodilator airflow limitation among smokers in Switzerland

Patient-reported respiratory symptoms and pre-bronchodilator airflow limitation among smokers in Switzerland

COPD in Chinese nonsmokers

Reconsidering sex-based stereotypes of COPD

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