Prolonged hormonal exposure has been linked to an increased severity of asthma among Caucasian women. Our aim is to determine if the same is true or are there differences in the severity of asthma among premenopausal(PREM) vs postmenopausal(PM)African American(AA)women.
We enrolled 37 women ages 18-82, who were admitted through the emergency department over a 2-year period with asthma exacerbation. In this retrospective chart review, asthma severity was defined by the National Heart Lung and Blood Institute guidelines. Menopause was defined as cessation of the menstrual cycle by natural or surgical means.Additionally, body mass index (BMI), age of onset of menarche and number of cigarette pack years (CPY) of smoking were recorded.
Twenty (58.5%)of the women were PM, and 17 (41.5%)were PREM. The mean ages were 35+/-8.2 for PREM and 60+/-10 for PM women. There was no significant difference in population demographics except for CPY, that was statistically greater in PM women P=0.003. Multivariate analysis was used to control for BMI, CPY, number of pregnancies, highest educational level and onset of menarche. Eighty percent of PM and 55.8% of PREM women had a BMI >30, (40% of PM vs 29%of PREM had BMI’S > 40). P = 0.68 between the groups. Average onset of menarche in the PREM vs PM group was 11.2+/-2.8 and 13.4 +/-2.7, P = 0.9. Chi-Square test was used in the analysis of the asthma severity. Although there was a percentage trend to more severe asthma in the PM group, it was not statistically significant P = 0.189.
Women in the PM group had shorter duration of hormonal exposure, however an increased severity of asthma. While not explained by population characteristics except CYP and BMI that were not statistically significant, nonetheless, severe obesity rather than hormonal changes may be the primary factor in asthma severity among PREM and PM AA women.
Asthma severity in PREM vs PM AA women may need to be evaluated using different parameters. Further studies are required.
Reverly John, None.