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Gender and COPD in Patients Attending a Pulmonary Clinic^*

^* From the Respiratory Research Unit (Drs. de Torres, Casanova, Hernandez, Abreu, and Aguirre-Jaime), Hospital Nuestra Sra de Candelaria, Tenerife, Spain; and Pulmonary and Critical Care Division (Dr. Celli), St. Elizabeth's Medical Center, Boston, MA.

Correspondence to: Juan Pablo de Torres, MD, Unidad de Investigación, Hospital Ntra Sra de Candelaria, Ctra del Rosario s/n, 38010 Santa Cruz de Tenerife, Canary Islands, Spain; e-mail: jupa65{at}hotmail.com

Objectives: To compare gender differences in the clinical expression of COPD patients attending a pulmonary clinic.

Materials and methods: We compared 53 FEV₁-matched men and women with COPD attending a pulmonary clinic. We studied age, smoking pack-years history, PaO₂, PaCO₂, functional residual capacity, body mass index (BMI), dyspnea, 6-min walk distance (6MWD), health-related quality of life, presence of comorbidities, and exacerbations in the previous year.

Results: Women were younger (57 years vs 65 years, p < 0.05), smoked less (48 pack-years vs 69 pack-years, p < 0.05), had better PaO₂ (74 mm Hg vs 67 mm Hg, p < 0.05), lower PaCO₂ (40 mm Hg vs 45 mm Hg, p < 0.05), lower BMI (25 vs 28, p < 0.05), more exacerbations in the last year (1 vs 0, p < 0.05), and fewer comorbidities (Charlson score 2 vs score 4, p < 0.05) than men. Even though women had the same FEV₁, better oxygenation, better PaCO₂, and fewer comorbidities, they performed poorer in walking distance (6MWD percentage of predicted, 87% vs 105%; p = 0.05), had worse quality-of-life scores (Saint George’s Respiratory Questionnaire [SGRQ] symptoms score, 51 vs 41, p < 0.05; SGRQ activity score, 58 vs 47, p < 0.05), and had a higher degree of dyspnea (Modified Medical Research Council scale > 2, 28% vs 6%, p = 0.05).

Conclusions: In a population of patients with COPD attending a pulmonary clinic, there are gender-related differences in the clinical expression of COPD that need further attention.

Key Words: clinical presentation • COPD • gender

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