Cardiovascular Comorbidities in Chronic Obstructive Pulmonary Disease (COPD)—Current Considerations for Clinical Practice

Abstract

In patients with chronic obstructive pulmonary disease (COPD), cardiovascular comorbidities are highly prevalent and associated with considerable morbidity and mortality. This coincidence is increasingly seen in context of a “cardiopulmonary continuum” rather than being simply attributed to shared risk factors such as cigarette smoking. Overlapping symptoms such as dyspnea or chest pain lead to a worse prognosis due to missed concomitant diagnoses. Moreover, medication is often withheld as a result of unfounded concerns about side effects. Despite the frequent coincidence, current guidelines are still mostly restricted to the management of the individual disease. Future diagnostic and therapeutic strategies should therefore be guided by an integrative perspective as well as a refined phenotyping of disease entities.

Secondary prevention through comprehensive cardiovascular rehabilitation: From knowledge to implementation. 2020 update. A position paper from the Secondary Prevention and Rehabilitation Section of the European Association of Preventive Cardiology

“…The coincidence is increasingly seen in the context of a 'cardiopulmonary continuum' rather than being simply attributed to shared risk factors such as smoking. 145 This leads to a relevant proportion of cardiac patients with COPD, currently around 6% to 20% in contemporary European cardiac rehabilitation programmes. 105,110 Advanced COPD stages are associated with a deterioration of exercise capacity, cachexia and skeletal muscle dysfunction, comparable to patients with heart failure.…”

The clinical course of arterial hypertension in patients with chronic obstructive pulmonary disease and obesity

“…ХОЗЛ асоційоване з ризиком виникнення гіпертензії, що зумовлено старінням населення та спільними ризик-факторами, які впливають на розвиток даної коморбідності [1][2][3]. Серед них важливими є: вікові зміни, асоційовані з прогресуючою гіподинамією, зростанням маси тіла; стать, спадковість, метаболічний синдром, тютюнопаління, гіперурикемія, оксидативний стрес та системний запальний процес, що ймовірно виникає внаслідок ефекту розпилення (overspill effect) [4][5][6].…”

Comorbidities and medical course in a young patient diagnosed with severe obstructive sleep apnea

“…The process is further accelerated by systemic inflammation and oxidative stress (7). As a result, approximately one out of six COPD patients suffers from concomitant CHD (8). Endothelial function is known to be impaired in subjects with chronic heart failure (CHF), which is a syndrome rather than a disease (9).…”

“…Nevertheless, the overall elevated cardiovascular risk in COPD may be a product of this common condition and potentiating effects of other risk factors such as diabetes mellitus and cigarette smoking. Moreover, higher central blood pressure values and arterial stiffness are also found indicating premature atherosclerosis (8). The coexistence of COPD, CVDs and major risk factors for CVD highlights the crucial need for the development of strategies to screen for and reduce cardiovascular risks the samples were frozen and stored at -20°С.…”