The effect of sex on asthma control from the National Asthma Survey

Michael Calvin

The long and short of it is that the short and long term measures of asthma control demonstrate significant differences between the sexes, and women get the short end of the stick in both instances. This study published in the April Journal of Allergy and Immunology demonstrates significant differences between the sexes, with female subjects having worse short-term asthma control in terms of recent asthma attacks, uncontrolled daytime and nighttime symptoms in the prior 30 days, and recent albuterol use for an asthma attack. Women were more likely to have used a rescue inhaler for an asthma attack in the prior 3 months than men. All long-term measures of asthma control looked at in this study revealed poorer control among women. Two measures of health care use, urgent-care visits and hospitalizations, were found to be higher in female subjects in this study, as well as in several other studies. One possible explanation for the larger differences demonstrated between the sexes for the long-term measure is that women might seek care more readily than men because of a greater knowledge or perception of asthma control. Also, women might experience greater disability from their asthma because of a greater frequency of asthma attacks or a greater severity of asthma.

Other studies have also shown higher rates of routine asthma care in female asthmatic subjects and worse asthma control among female subjects. Higher rates of routine asthma care in women with worsened asthma control could also reflect a better awareness of worsening lung functions or a greater comprehension of well-controlled versus poorly controlled asthma among women.

Although this study and others support differences in asthma control between the sexes, it is possible that asthmatic female subjects report more problems than male subjects with similar levels of illness. Although men have higher death rates than women, many studies have demonstrated higher illness and health care use for women. So, it may be a matter of perception, but perception is reality. Women may complain more, but men die more.

2009-04-24