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COPD: a systemic disease or a co-morbid condition?
P46 Gender differences in the prevalence of comorbidities in COPD patients
  1. A R C Patel,
  2. G C Donaldson,
  3. A J Mackay,
  4. J A Wedzicha,
  5. J R Hurst
  1. Academic Unit of Respiratory Medicine, UCL Medical School, London, UK


Introduction Effective recognition and appropriate management of comorbidities is an important aspect of modern COPD care. In particular, cardiovascular diseases are a leading cause of morbidity and mortality. There is increasing interest in the differential impact of gender in COPD. This study aims to characterise gender differences in the profile of comorbidities in COPD.

Methods We analysed the recruitment records of 386 well-characterised patients enrolled into the London COPD Cohort. Comorbidities, medication, age, gender, height, weight, spirometry, St George's Respiratory Questionnaire (SGRQ) and MRC dyspnoea scores were recorded.

Results There were no significant differences between females (n=164) and males (n=222) in terms of mean ± SD age; 67.5±8.3 vs 69.0±9.0 years, p=0.102, median (IQR) smoking pack year history 47 (27–62) vs 44 (27–65), p=0.769 or body mass index 25.3 (22.1–29.4) vs 25.5 (22.8–29.0), p=0.311. Females had milder airflow limitation at recruitment with a higher mean ± SD FEV1 % predicted; 53.5±19.9 vs 46.4±18.9, p<0.001. Following adjustment for FEV1 % predicted, there were no gender differences in SGRQ (51.2±18.6 vs 49.8±19.5, p=0.127) or MRC dyspnoea scores (3.0 (2.0, 4.0) vs 3.0 (2.0, 4.0), p=0.104). Cardiovascular conditions were more common in male COPD patients (Abstract P46 figure 1), whereas of the clinically significant comorbidities, only osteoporosis was more common in females (10.4% vs 2.7%, p=0.001).

Abstract P46 Figure 1

Gender differences in the prevalence of cardiovascular diseases in COPD. MI, myocardial infarction, CVA, cerebrovascular accident, TIA, transient ischaemic attack; PVD, peripheral vascular disease; IHD, ischaemic heart disease, CV, cardiovascular.

Conclusions The excess cardiovascular disease in COPD patients is predominantly found in men despite lower gender differences in cardiovascular risk factors such as smoking history, diabetes, hypercholesterolaemia and hypertension. This may partly represent under-diagnosis of cardiovascular disease in COPD patients. Clinical vigilance must be maintained to identify and optimally manage important comorbidities in all COPD patients, although clinicians should be aware of the increased prevalence of cardiovascular disease in men and osteoporosis in women.

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