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Is Gender Linked to Differences in COPD Symptoms and Cardiac Disease?


Gender-specific chronic obstructive pulmonary disease (COPD) symptoms identify differences among men and women as good predictors for cardiac comorbidities.

A relationship was identified between gender and chronic obstructive pulmonary disease (COPD) that may be useful from a clinical standpoint for better diagnosing and predicting of cardiac comorbidities.

Many studies have found differences in between men and women regarding COPD symptoms and comorbidities, which may be due to differences in risk factors, psychological differences, social, and behavioral factors. This study aimed to observe gender-specific differences in COPD symptoms and to see if they could predict cardiac comorbidities. The results were published in Clinical Research in Cardiology.

This analysis was based on a total of 2741 patients (GOLD grades 1-4) aged 40 and older, with stable COPD from the COSEYCONET COPD cohort. From the total, 2046 participants (795 female) were included in the study. An individual’s clinical history, comorbidities, and lung function was obtained from CAT and mMRC assessments. Cardiac comorbidities included myocardial infarction, heart failure, and coronary artery disease.

To evaluate the relationship to cardiac disease, regression analysis was performed separately between men and women.

Researchers found that most functional parameters and comorbidities, as well as CAT items 1 (cough), 2 (phlegm), and 5 (activities) differed significantly (P < .005) between men and women.

Furthermore, the researchers found the relationship between functional parameters and comorbidities v symptoms showed gender-specific differences, especially for single CAT items.

In men, item 8 (energy), mMRC, smoking status, body mass index (BMI), age, and lung function were strong predictors of cardiac disease, while age was the primary predictor in women.

Not only did the researchers identify gender-specific differences in COPD regarding symptoms and cardiac comorbidities, but they also found differences in their mutual relationships, suggesting that diagnostic information may be different between men and women.

The researchers acknowledged that there some limitations to the study, including that its cross-sectional approach could only make correlations, not causal relationships. Additionally, the presence of cardiac disease was driven from patient-reported diagnosis by physicians and was not necessarily based on guidelines.

“Using data from a large COPD cohort, we observed that COPD symptoms measured by single COPD Assessment Test (CAT) items and modified Medical Research Council dyspnea scale (mMRC) showed relationships to functional and clinical status as well as comorbidities that differed between men and women,” the researchers concluded.

Gender-specific differences observed in COPD symptoms suggest that predicators for cardiac comorbidities may be different among men and women with COPD.

“These differences were also apparent in different sets of measures, including symptoms, indicative for cardiac disease in men and women,” conclude the researchers. “As a potential application, the findings suggest that in men with COPD, elevated scores of one CAT item (energy) should motivate a cardiovascular diagnostic work-up, while in women the situation is more difficult, as a result of the overall lower prevalence of cardiac diseases.”


Trudzinski FC, Kellerer C, Jörres RA, et al. Gender-specific differences in COPD symptoms and their impact for the diagnosis of cardiac comorbidities. Clin Res Cardiol. 2023;112(2):177-186. doi:10.1007/s00392-021-01915-x

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