Chronic obstructive pulmonary disease: are women more susceptible than men?

For most physicians in North America, the term "chronic obstructive pulmonary disease" (COPD) conjures up the image of an elderly man, plagued by cough, wheeze, and breathlessness after many years of cigarette smoking so that his "golden years" of well-deserved retirement are instead a misery of chronic illness and death by suffocation. This stereotype is outdated and misleading. The typical North American patient who has COPD is: (1) more likely to be a woman, (2) more likely to manifest disease symptoms and disability much younger than her male counterpart, and (3) at risk of developing these manifestations of chronic disabling disease with a minimum of exposure to tobacco smoke and, in some instances, no smoking history at all. There is compelling evidence that women are more susceptible than men to the development of chronic airflow limitation. COPD is now a women's health care issue. This article traces the changing epidemiology of COPD and the evidence that women are at greater risk than men for developing this lethal illness.