Women manifest more severe COPD symptoms across the life course.

Background: Previous studies suggest that gender differences exist in COPD diagnosis and symptoms; these differences may be more pronounced in younger adults. Our objective was to explore age-associated gender differences across a range of COPD severities.
Materials and Methods: A total of 4,484 current and former smokers with COPD from the Genetic Epidemiology of COPD cohort were investigated using regression modeling to explore the association between gender, age, disease severity, and the contributing elements of the Global Initiative for Chronic Obstructive Lung Disease (GOLD) classification system (symptoms, exacerbation risk, airflow limitation).
Results: The age-gender interaction was observed across multiple age categories. Compared to men with COPD, younger women with COPD had a greater likelihood of more severe dyspnea, airflow limitation, greater risk for exacerbations, and categorization in GOLD groups B and D. These differences were less pronounced in older women with COPD. However, older women remained more likely to experience severe dyspnea and to manifest more severe COPD (B vs A) than older men, despite lower pack-years of smoking.
Conclusion: These data demonstrate the significant symptom burden of COPD in women, especially younger women. More research is needed to understand the pathogenesis of increased severity of COPD in women and to develop gender-targeted clinical assessment and management approaches to improve outcomes for women and men with COPD at all ages.
Competing Interests: Disclosure DL DeMeo, MD, reports receiving grants from the National Institutes of Health and consultation fees from Novartis. S Ramagopalan, PhD, was an employee of Evidera Inc. (scientific consulting) at the time of the study. A Kavati, PhD, is an employee of Novartis Pharmaceuticals. A Vegesna, PharmD, is an employee of Novartis Pharmaceuticals. MK Han, MD, reports consulting income from GSK, Boehringer Ingelheim, AstraZeneca, Sunovion she also reports research support from GSK and Novartis. A Yadao, MD, is an employee of Novartis Pharmaceuticals. TK Wilcox, PhD, is an employee of Evidera Inc. (scientific consulting). BJ Make, MD, related to the topic of COPD, reports funding from the National Heart, Lung, and Blood Institute for the COPDGene study, grants, and personal fees from Boehringer Ingelheim, AstraZeneca; personal fees and other from Spiration, Consensus Medical Education, Integrity Medical Education, Mt Sinai Medical Center, WebMD, Up-To-Date, National Jewish Health; grants, personal fees, and other from GlaxoSmithKline, Sunovian; personal fees from Novartis, CSL Bering, Verona; other from SPIRE Learning, American College of Chest Physicians, Projects in Knowledge, Hybrid Communications, Peer Review Institute, National Jewish Health, Cleveland Clinic; grants from Pearl; grants and other from Medscape, outside the submitted work. The authors report no other conflicts of interest in this work.