For a long time, chronic obstructive pulmonary disease (COPD), a progressive lung disease, was considered a ‘man’s disease.’ But that is no longer the case.
“Women are more likely to have COPD than men,” said Suzette A. Garafano, MD, clinical director of the COPD Program at NYU Langone Health. “But women are less likely to be diagnosed with this disease.”
Underdiagnosis is one reason why it is important for women to know the signs and symptoms of COPD. Women also experience COPD differently than men. “In general, women tend to develop COPD at a younger age, have more severe symptoms and lower lung function than men for the same level of tobacco exposure,” Dr. Garafano said.
We asked Garafano about some of the more important COPD facts women need to know.
Read: Women and COPD >>
What is COPD and what conditions does it cover?
COPD is a chronic lung disease caused by damage and inflammation of the airways and lung tissue. Over time, this damage interferes with the ability of air to flow smoothly in and out of the lungs, causing chronic respiratory symptoms of COPD. The disease is progressive and irreversible.
In the United States, most COPD cases are caused by cigarette smoke. There are basically two types of COPD: chronic bronchitis and emphysema.
People with chronic bronchitis tend to have more inflammation and damage to their airways, which leads to chronic coughing and mucus production. People with emphysema tend to have less airway damage and more damage to lung tissue, especially the air sacs. People with emphysema tend to cough and produce less phlegm, but shortness of breath occurs more often and becomes more severe.
In reality, most people with COPD have a little of both.
What are the common symptoms of COPD?
The most common symptoms of COPD are difficulty breathing, coughing, excessive production of thick mucus, wheezing, and chest tightness. However, not everyone with COPD has the same symptoms and the severity of symptoms may vary.
How are asthma and COPD different and similar?
Asthma and COPD have some things in common. Asthma tends to develop at a younger age than COPD, but can develop at any age. Asthma is often caused by allergies, resulting in a type of airway inflammation called allergic or commonly called eosinophilic.
COPD is also an inflammatory disease, and some people with COPD have allergic inflammation, but most do not. COPD is more often caused by inhaled irritants, such as cigarette smoke and tobacco smoke, than by allergies. Although the medications used to treat asthma and COPD are very similar, people with more severe allergic inflammation tend to respond better to anti-inflammatory treatments, including inhaled corticosteroids.
How does your environment increase your risk of COPD?
There are several environmental factors that can cause or worsen COPD. In addition to a person’s smoking history, exposure to secondhand smoke can also cause COPD.
Certain occupations that expose workers to dust fumes or chemicals, or to known causes of COPD pollution (both indoor and outdoor), are now increasingly recognized as causes of COPD.
A component of outdoor air pollution, particulate matter called PM 2.5, caused by traffic and industry, is most commonly associated with all types of lung disease.
Fine dust is indoors even when we don’t think it is there. This is more applicable to low- and middle-income countries, where women have very high rates of COPD due to exposure to biomass fuels such as coal and wood used for heating and cooking.
Read: How air quality affects COPD >>
What role do genetics play in COPD?
The only confirmed genetic disorder that causes COPD is alpha-1 antitrypsin (AAT) deficiency, and although AAT levels should be tested in COPD patients, it is also responsible for a very small percentage of COPD cases.
About one in four people with COPD have never smoked, so there must be other factors affecting the likelihood of developing the disease, and new research techniques are identifying numerous genetic variants associated with COPD. However, it is currently unclear how these variants are involved in the development of COPD or the likelihood of developing the disease.
What complications can arise from COPD?
COPD is associated with many comorbidities. Some of these are due to the common risk factor of smoking, but some others are directly linked to the effects of COPD itself. As we all know, lung cancer is mostly caused by smoking, but COPD is also an independent risk factor for lung cancer.
Heart disease has been linked to COPD, especially when it is more advanced. This can occur in heart failure, especially on the right side of the heart, the side of the heart that pumps blood to the lungs. In patients with severe COPD, low oxygen levels can lead to pulmonary hypertension, a serious condition.
COPD may predispose people to recurrent respiratory infections. This can eventually lead to lung damage, a condition called bronchiectasis. Pulmonary fibrosis is associated with emphysema.
COPD has also been linked to type 2 diabetes and metabolic syndrome. Although the link is not entirely clear, it is probably related to the systemic inflammatory effects of COPD.
Are there lifestyle changes that can help improve COPD symptoms?
The most important lifestyle change is to stop smoking.
Symptoms such as coughing and phlegm production may improve fairly quickly if you stop smoking.
Exercise is also a very effective way to improve COPD symptoms. Starting a regular cardiovascular exercise program will improve your muscle strength, allowing your body to use oxygen more efficiently and ultimately reduce shortness of breath.
Pulmonary rehabilitation programs are available for people with more advanced COPD. This is a medically supervised exercise program that has been proven to improve shortness of breath, improve quality of life, and actually reduce mortality from disease.
What treatments are available for COPD?
The mainstay of COPD treatment remains bronchodilators, usually administered via inhalers.
In a broad sense, bronchodilators are of two types: Each works by using different methods to expand the airway.
Inhaled corticosteroids are less frequently used to treat COPD but may be helpful in people with allergic types of inflammation.
In the past few years, two new classes of drugs have been shown to help COPD. This is very exciting because there have been no new classes of drugs for COPD for many years.
One is a nebulized medication that has both bronchodilator and anti-inflammatory properties, and studies have shown it to be effective in improving symptoms in people with COPD.
There are also injectable medications called biologic therapies currently being used for COPD. The drug has been around for about 10 years and has had remarkable success in asthma patients, and has now been found to be effective in COPD patients with allergic types of inflammation.
This is very interesting, and a lot of research is being done to find biological agents that are effective in the COPD patient population without the allergic type of inflammation.
For patients with more advanced COPD, there are invasive interventions and, for those candidates, lung transplantation.
This training material was created with support from:m I asked.
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