Female smokers beyond the perimenopausal period are at increased risk of chronic obstructive pulmonary disease: a systematic review and meta-analysis

• Main Authors: Postma Dirkje S, Man SF, Gan Wen, Camp Patricia, Sin Don D
• Format: Article
• Language: English
• Published: BMC 2006-03-01
• Series: Respiratory Research
• Online Access: http://respiratory-research.com/content/7/1/52

<p>Abstract</p> <p>Background</p> <p>Recent reports indicate that over the next decade rates of chronic obstructive pulmonary disease (COPD) in women will exceed those in men in the western world, though in most jurisdictions, women continue to smoke less compared with men. Whether female adult smokers are biologically more susceptible to COPD is unknown. This study reviewed the available evidence to determine whether female adult smokers have a faster decline in forced expiratory volume in one second (FEV₁) compared with male adult smokers and whether age modifies the relationship between cigarette smoke and lung function decline.</p> <p>Methods</p> <p>A systematic review and a meta-analysis was performed of population-based cohort studies that had a follow-up period of at least 3 years, measured FEV₁on at least two different time points, and presented FEV₁data stratified by gender and smoking status in adults.</p> <p>Results</p> <p>Of the 646 potentially relevant articles, 11 studies met these criteria and were included in the analyses (N = 55 709 participants). There was heterogeneity in gender-related results across the studies. However, on average current smokers had a faster annual decline rate in FEV₁% predicted compared with never and former smokers. Female current smokers had with increasing age a significantly faster annual decline in FEV₁% predicted than male current smokers (linear regression analysis, R²= 0.56; p = 0.008). Age did not materially affect the rate of decline in FEV₁% predicted in male and female former and never smokers (p = 0.775 and p = 0.326, respectively).</p> <p>Conclusion</p> <p>As female smokers age, they appear to experience an accelerated decline in FEV₁% predicted compared with male smokers. Future research powered specifically on gender-related changes in lung function is needed to confirm these early findings.</p>