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For a long time, chronic obstructive pulmonary disease (COPD), a progressive lung disease, was considered a “men’s disease”. But that is no longer the case.
“Women are more likely to develop COPD than men,” said Suzette A. Garafano, MD, clinical director of the COPD program at NYU Langone Health. “Despite this, women are less likely to be diagnosed with the disorder.”
This underdiagnosis is one of the reasons why it is important for women to know the signs and symptoms of COPD. Additionally, women do not suffer from COPD in the same way as men. “In general, women tend to develop COPD at a younger age, are more symptomatic, and have worse lung function than men with the same exposure to tobacco,” Garafano said.
We asked Garafano about the most important COPD information women should know.
Read: Women and COPD >>
What is COPD and what diseases fall under this classification?
COPD is a chronic lung disease caused by injury and inflammation of the lung tissue and airways. Over time, these lesions impede the ability of air to flow smoothly in and out of the lungs, which in turn causes the chronic respiratory symptoms of COPD. This disorder is progressive and irreversible.
In the United States, the vast majority of 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 the airways, leading to chronic coughing and mucus production. People with emphysema tend to have fewer respiratory tract lesions and more lung tissue lesions, particularly in the alveoli. People with emphysema tend to have less cough and phlegm, but they experience difficulty breathing more frequently and more severely.
In fact, most people with COPD have mild levels of both conditions.
What are the most common symptoms of COPD?
The most common symptoms of COPD are shortness of breath, cough, excessive production of thick mucus, wheezing, and chest tightness. However, not all people with COPD have the same symptoms and the severity can 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 occur at any age. Allergies often cause asthma and lead to an allergic inflammation of the airways, often called eosinophilic.
COPD is also an inflammatory disease, and while some COPD patients experience allergic inflammation, most do not. COPD is usually the result of inhaling irritants such as tobacco or cigarette smoke, rather than allergies. And although the medications we use to treat asthma and COPD are very similar, people with allergic inflammation tend to respond better to anti-inflammatory treatments like inhaled corticosteroids.
How does your environment increase your risk of COPD?
There are some environmental factors that can cause or worsen COPD. In addition to a personal smoking history, passive smoking is also a cause of COPD.
Certain occupations where workers are exposed to dust emissions, chemicals or known causes of COPD pollution, i.e. indoor and outdoor pollution, are increasingly recognized as causes of COPD.
There is a component of outdoor air pollution, suspended particulate matter called PM 2.5, which is a product of traffic and industrial activities and is more commonly associated with all types of lung diseases.
There are also suspended particles indoors, even if we don’t think about them indoors. This is particularly true in low- and middle-income countries, where women often have very high rates of COPD due to exposure to biofuels 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 genetic disorder proven to cause COPD is something called alpha-1-antitrypsin (AAT) deficiency and is the cause of a very small percentage of COPD cases, although every COPD patient should have AAT levels checked.
About one in four people who develop COPD have never smoked. So there must be other factors that influence a person’s risk of developing COPD, and recent research techniques have identified many genetic variations that are linked to COPD. However, it is currently not clear what role these variations play in the development of COPD or the chances of developing it.
What complications can occur with COPD?
COPD is associated with many comorbidities. Some of this is due to the common risk factor of smoking, but other diseases are directly linked to the effects of COPD. As we all know, lung cancer is most often a result of smoking, but COPD is also an independent risk factor for lung cancer.
Heart disease is associated with COPD, especially in more advanced stages. It can cause heart failure, especially on the right side of the heart, the side that pumps blood to the lungs. In people with severe COPD and low oxygen levels, this can lead to pulmonary hypertension, a serious condition.
COPD predisposes people to developing recurrent respiratory infections. This, in turn, can lead to scarring of the lungs called bronchiectasis. Pulmonary fibrosis is accompanied by emphysema.
A link has also been found between COPD and type 2 diabetes and metabolic syndrome. This connection is not yet clearly understood, but is probably due 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.
When you stop smoking, symptoms such as coughing and mucus production may subside quickly.
Exercise is also an effective way to relieve COPD symptoms. Starting a regular cardiovascular exercise program increases muscle strength, allowing our bodies to use oxygen more efficiently, which in turn reduces shortness of breath.
Pulmonary rehabilitation programs are available for people with advanced COPD. There are medically supervised exercise programs that have been proven to relieve shortness of breath, improve quality of life, and reduce mortality rates from this disease.
What treatment options are there for COPD?
Treatment of COPD continues to rely primarily on bronchodilators, generally administered via inhalers.
In general, there are two types of bronchodilators. Each works in different ways to expand the airways.
Inhaled corticosteroids are less commonly used to treat COPD, but may be useful in people with allergic inflammation.
In recent years, two types of medications have been shown to provide relief from COPD, and that’s very exciting because we haven’t had a new COPD medication in many, many years.
One is a nebulized medication with bronchodilator and anti-inflammatory properties. Studies have shown it to be effective in relieving symptoms in people with COPD.
There are also injectable medications, called biologic therapies, that are used today for COPD. These medications have been available for about a decade, have proven extremely successful in people with asthma, and have also been shown to be effective in people with COPD and allergic inflammation.
This is very exciting and there is a lot of research going on into these biological agents to find out which ones are effective for the majority of people with COPD who do not have allergic inflammation.
For people with advanced COPD, there are invasive procedures and lung transplants in appropriate individuals.
This educational resource was created with support from Chiesi.
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