COPD: Breathtaking Differences
Finding the differences in how COPD affects men and women
BY:MYRA DEMBROW
Men and women experience chronic obstructive pulmonary disease (COPD) so differently that the same treatments may not work for both sexes.COPD is a combination of emphysema and chronic bronchitis often caused by a combination of smoking, aging and pollution. A study of 1,000 patients at the University of Michigan found women were more likely to have chronic bronchitis, while men were more likely to have emphysema. Women also reported more breathlessness, depression and disability than men.
The findings, reported in the American Journal of Respiratory and Critical Care Medicine, indicate that "the treatments for men and women are going to be inherently different," says lead researcher Fernando J. Martinez, MD, MS, professor of internal medicine, division of pulmonary and critical care, University of Michigan. They also mean "physicians need to continue to raise the awareness of COPD in women," says Dawn L. DeMeo, MD, MPH, instructor in medicine, Harvard Medical School. "It is a diagnosis that has not reached prominence in women. We need to raise awareness not only among lung specialists but also among basic healthcare providers."
Other University of Michigan researchers are calling for more diagnostic testing to assess lung health by measuring volume and flow. Their study, published in the journal Chest, found that about two-thirds of 5,000 patients diagnosed with COPD never took a spirometry test, in which a person breathes into a mouthpiece connected to a device (spirometer) that records the amount and the rate of air that is inhaled and exhaled over a specified time. Some of the test measurements are obtained by normal breathing, while other test parts require forced inhalation or exhalation after a deep breath.
Only half of the patients who took a spirometer test followed up with a test to determine whether they needed to take a bronchodilator, which is a drug that comes in short- and long-acting varieties and works by relaxing the muscles around airways.
"Without proper testing, both underdiagnosis and misdiagnosis may occur, which can lead to improper therapies being prescribed," says lead author Meilan Han, MD, medical director, women's respiratory health program, department of internal medicine, University of Michigan. "This study shows that we have a lot of work ahead of us in terms of raising awareness among both patients and physicians."