COPD (or chronic obstructive pulmonary disease) is the second respiratory disease (after asthma) in France and it is about to become the 3rd cause of death in the world. COPD, which affects more than 3 million patients in France, is manifested by a slow and progressive obstruction of the airways and lungs, with a decrease in expiratory flows. There is currently no cure, but early treatment can slow the progression of the disease and reduce the symptoms.
Smoking is the main cause of the disease. However, 20% of people with COPD are non-smokers, a phenomenon that has puzzled many doctors until now. But in a study published in Jamaresearchers at Columbia University in the United States finally provide an explanation.
Dysanapsia, a new cause of COPD
American researchers have discovered that an abnormality of the lungs called dysanapsis can lead to a risk of COPD. People with dysanapsis have small airways compared to the volume of their lungs. This size mismatch between airway branches and lung volume prevents proper functioning of the respiratory tree and increases the risk of COPD as people age.
For this study, Columbia University researchers analyzed lung CT scans of more than 6,500 seniors enrolled in 3 large lung studies in the United States and Canada. They found that people with smaller airways relative to the size of the lungs had lower lung function and an 8 times higher risk of developing a respiratory disease like COPD.
COPD also affects young women
Even if female smoking is down slightly, one in 5 women smokes daily. However, women are biologically more vulnerable to the toxic effects of tobacco and have a higher risk than men of developing a smoking-related disease. like lung cancer of course, but also like COPD.
This vulnerability means that for the same number of cigarettes, women will tend to develop COPD much earlier than men, but also in a more severe form. “The number of women with COPD has been increasing steadily by 1.7% per year since the end of the 1970s. In France, it is 1 million” explains Professor Chantal Raherison, pulmonologist and President of the “Women and Lungs” group of the French-speaking Pneumology Society (SPLF).
However, women are still largely under-diagnosed: “a situation attributable to an anachronistic vision of the disease that we still too often associate with men, for lack of awareness of the feminization of smoking” explains Dr. Frédéric Le Guillou, pulmonologist and president of theRespiratory Health Association France.“The face of the disease is changing. The patient with COPD is no longer a man over 50, smoker or ex-smoker, who spits and coughs. The disease has become feminized and rejuvenated” insists Professor Chantal Raherison.
What are the symptoms of the illness ?
COPD is a slow onset disease. The symptoms (cough, sputum, fatigue, breathing difficulties) seem harmless and do not necessarily suggest an illness.
Symptoms are greater and more severe in women. The latter suffer less from emphysema (a disease of the pulmonary alveoli) than men but suffer from a greater deterioration in respiratory function with:
- no more nocturnal cough
- more difficulty breathing (called dyspnea)
- more fatigue
- an associated depressive syndrome.
There is also a greater number of hospitalizations among women and a much more impaired quality of life. “In women, the doctor will more spontaneously think of asthma than COPD” regrets Emilie Zard, head of clinic at the Créteil Hospital Center. This delays the diagnosis and has a negative impact on the evolution of the disease which should be recognized early to limit the damage. To improve this screening, breath measurement should thus become as systematic as blood pressure measurement.
How is it treated?
Treatment begins with smoking cessation to slow the decline in lung function. A step often more difficult for women than for men because they are afraid of gaining weight. “If we do not have differentiated care, and we do not associate weaning with dietary or psychological support, the risk of weaning failure will be greater” explains Professor Chantal Raherison.
Medicines (corticosteroids, bronchodilators) also help to dilate the bronchi and facilitate the passage of air. Finally, respiratory rehabilitation can reduce shortness of breath and reaccustom the muscles to work.
Read also :
- COPD: the forgotten part of the anti-tobacco plan
- COPD: 3 things to know
- COPD: the unmistakable signs