Clinical Features Of Women With COPD: Sex Differences In A Cross-Sectional Study In Spain ("The ESPIRAL-ES Study")

Int J Chron Obstruct Pulmon Dis. 2019 Nov 5:14:2469-2478. doi: 10.2147/COPD.S217921. eCollection 2019.

Abstract

Aim: This cross-sectional multicenter study was performed aimed at describing the clinical characteristics of women with COPD attended in routine daily practice in Spain.

Methods and results: Of a total of 1610 consecutive patients diagnosed with COPD recruited in primary care centers and pneumology services throughout Spain over a 90-day period, 17.9% (n=286) were women, with a median age of 62 years. Differences in COPD phenotypes by sex were statistically significant (P = 0.002). Males as compared with females showed a higher prevalence of non-exacerbator (47.9% vs 42.2%) and exacerbator with chronic bronchitis (22.9% vs 18.8%) phenotypes, whereas the ACOS phenotype was more common among females (21.7% vs 12.9%). The mean (SD) CAT score was similar in men than in women (20.8 [9.0] vs 21.2 [8.7], P = 0.481), as well as the impact of the disease on the quality of life according to CAT scores of <5 (no impact), 5-9 (low), 10-20 (medium), >20 (high), and >30 (very high). Sex-related differences according to smoking status were statistically significant (P < 0.001), with a higher percentage of men as compared with women in the groups of current smokers and ex-smokers; never-smokers were higher in women (9.1%) than in men (0.6%). The mean number of comorbidities was 2.01 (1.43) (95% CI 1.93-2.09) in males and 1.99 (1.42) (95% CI 1.83-2.16) (P = 0.930) in females, but cardiovascular diseases (hypertension, ischemic heart disease, chronic heart failure) were more frequent in men, whereas metabolic disorders (osteoporosis) were more frequent in women.

Conclusion: This study highlights the impact of COPD in women and the importance of continuing sex-based research in tobacco-related respiratory diseases.

Keywords: asthma; chronic bronchitis; chronic obstructive; phenotype; pulmonary disease; pulmonary emphysema; quality of life.

Publication types

  • Comparative Study
  • Multicenter Study
  • Observational Study

MeSH terms

  • Aged
  • Bronchitis, Chronic / diagnosis
  • Bronchitis, Chronic / epidemiology
  • Bronchitis, Chronic / physiopathology*
  • Comorbidity
  • Cross-Sectional Studies
  • Female
  • Health Status Disparities*
  • Humans
  • Lung / physiopathology*
  • Male
  • Middle Aged
  • Prevalence
  • Pulmonary Disease, Chronic Obstructive / diagnosis
  • Pulmonary Disease, Chronic Obstructive / epidemiology
  • Pulmonary Disease, Chronic Obstructive / physiopathology*
  • Pulmonary Emphysema / diagnosis
  • Pulmonary Emphysema / epidemiology
  • Pulmonary Emphysema / physiopathology*
  • Quality of Life
  • Risk Factors
  • Sex Factors
  • Smokers
  • Smoking / adverse effects
  • Smoking / epidemiology
  • Spain / epidemiology