Volume 20 Issue 4 December 2011
Reconsidering sex-based stereotypes of COPD
Pages 370-378
*Jill Ohara, Leonard Fromerb, James F Donohuec
a
Section on Pulmonary, Critical Care, Allergy and Immunologic Diseases, Wake Forest University Health Sciences, Medical Center Boulevard, Winston Salem, NC, USA
b
Department of Family Medicine, UCLA School of Medicine, Los Angeles, CA, USA
c
Division of Pulmonary Diseases and Critical Care Medicine, University of North Carolina School of Medicine, Chapel Hill, NC, USA
Received 7 October 2010 • Accepted 7 May 2011 • Online 16 September 2011
Abstract
Chronic obstructive pulmonary disease (COPD) has historically been considered a disease of older, white, male smokers, as illustrated in
Frank Netter’s classic images of the ‘pink puffer’ and ‘blue bloater’. However, women may be more susceptible to COPD than men, and
the disease course may be reflective of that increased susceptibility. From a review of epidemiological data of COPD, we found differences
in the way men and women present with COPD symptoms, a bias in the way COPD symptoms are treated in men and women, and
differences in susceptibility to airway obstruction based on age, sex, and smoking history. These data show that classic stereotypes of
COPD – including male predominance – should be abandoned, and that there are not two but multiple COPD phenotypes, which are
characterised by differences between women and men in susceptibility, symptoms, and disease progression. These differences impact on
physician perception. Although further research into this concept is needed, the differences we found should prompt, in the short term,
changes in the way (and in whom) COPD is evaluated, diagnosed, and treated; in the long term, these differences should prompt research
into the prognosis of COPD based on sex differences.
Cite as: Ohar J, Fromer L, Donohue JF. Reconsidering sex-based stereotypes of COPD. Prim Care Respir J 2011;20(4):370-378. DOI: http://dx.doi.org/10.4104/pcrj.2011.00070
Keywords
COPD, phenotypes, female, male, sex, gender, stereotypes
* Corresponding author. Jill Ohar Tel: +1 336 716 8426 Fax: +1 336 716 7277 Email: johar@wfubmc.edu | |
