Are Women With Asthma at Risk for Developing COPD Later in Life?

According to a recent study, published in the Annals of the American Thoracic Society, about 40% of women who have asthma are at risk to later develop COPD.¹ When this happens, it is called ACOS, which stands for Asthma/COPD Overlap Syndrome.  That's sure not good news.

Understanding ACOS

ACOS is a chronic respiratory condition that has been linked to:

• increased respiratory flare-ups
• hospitalizations
• higher healthcare costs, compared to asthma or COPD alone
• lower quality of life
• more complications

This condition is more common in women and there has been a significant increase in prevalence within the past few years, according to the study. Women with ACOS are more likely also to die from this condition than men are. There are a few other risk factors for ACOS beyond gender:

• older age
• cigarette smoking
• outdoor air pollution
• occupational exposure
• respiratory infections
• socioeconomic status

Previous research has failed to thoroughly compare these risk factors in smokers vs. non-smokers. This is significant, because there are more non-smokers with COPD that are women than there are men.

Details of the Study

So, the study referenced above was designed to further identify risk factors, especially in regard to women. Hopefully, this would help with establishing better prevention efforts in the future. Here are some of the details of the study:

• 4051 women with asthma were studied
• Participants were followed approximately 14 years after their asthma diagnoses
• Study looked at data that had been gathered between 1992 and 2015
• 42% of the women (1071) later developed COPD
• Regular smokers were more likely to develop ACOS
• But, 38% of those who did develop ACOS had never smoked

In addition to the risk factors previously identified in older studies, these researchers identified these additional risks:

• obesity
• rural residence
• lower education levels
• unemployment

Although researchers lacked the data to determine for sure why these risk factors mattered, they theorized that low socioeconomic status could result in both lack of health care and poor compliance with medications. We know that those things often lead to problems with asthma control. Interestingly, researchers also concluded that air pollution was not a risk factor for developing ACOS.

What Does This Mean for Women Who Have Asthma?

Well, the good news is that most of these risk factors can be addressed and improved over time. However, it will fall to both women with asthma and the healthcare community to become more proactive in their strategies for preventing ACOS risk and development.

If you are a woman who has asthma, as I am, it's important to take a look at areas in your healthy lifestyle that can be improved.

• Do you smoke? If so, make a plan to quit.
• Are you overweight? If so, start eating healthier and getting more active.
• Do you follow your asthma care plan consistently and is your asthma under control? If not, start improving in that area.

Every effort we make will reduce our risk of ending up with COPD as well, down the road. It's frightening, for sure, to think that we might one day have to content with both COPD and asthma. But it's reassuring to know that we do have some control over reducing this risk.