1 Introduction
Chronic obstructive pulmonary disease is an increasing health issue worldwide [1-5] and is expected to be the third leading
cause of death by 2020 [6, 7]. Similarly, the World Health Organization [8] reports that COPD is the fifth most common
cause of death and the tenth most burdensome disease worldwide. COPD is to be ranked as the fifth global burden of
disease by 2020 [9]. There appears to be a continuous rise in the incidence and morbidity of COPD in women between the
ages of 55 and 74