Complex chronic comorbidities of COPD

Abstract

Chronic obstructive pulmonary disease (COPD) is defined by fixed airflow limitation associated with an abnormal pulmonary and systemic inflammatory response of the lungs to cigarette smoke.The systemic inflammation induced by smoking may also cause chronic heart failure, metabolic syndrome and other chronic diseases, which may contribute to the clinical manifestations and natural history of COPD. Thus COPD can no longer be considered a disease only of the lungs, as it is often associated with a wide variety of systemic consequences.A better understanding of the origin and consequences of systemic inflammation, and of potential therapies, will most likely lead to better care of patients with COPD. Medical textbooks and clinical guidelines still largely ignore the fact that COPD seldom occurs in isolation.As the diagnosis and assessment of severity of COPD may be greatly affected by the presence of comorbid conditions, the current authors believe that lung function measurement, noninvasive assessment of cardiovascular and metabolic functions, and circulating inflammatory markers (e.g. C-reactive protein) might help to better characterise these patients. Similarly, preventive and therapeutic interventions should address the patient in their complexity.

Pharmacological modulation of β-adrenoceptor function in patients with coexisting chronic obstructive pulmonary disease and chronic heart failure

“…This high prevalence of CHF in patients with COPD is not surprising, because COPD and CHF share smoking as a common risk factor, and, moreover, it is likely that low-grade systemic inflammation accelerates progression of coronary atherosclerosis, which ultimately results in ischemic cardiomyopathy [8].…”

Systemic manifestations and comorbidities of COPD

“…However, it has proved difficult to discover novel treatments for COPD, other than bronchodilators [158]. The other aspect that is now emerging is that treatments for certain comorbidities may also unexpectedly benefit COPD and indeed may provide the basis for future therapeutic approaches [159,160].…”

The Risk Factors and Specific Features of Osteopenic Syndrome in Patients With Chronic Non-Infectious Diseases

“…Согласно данным, опублико-ванным Всемирным банком и Всемирной организацией здравоохранения (ВОЗ), предполагает-ся, что в 2020 г. она выйдет на 5-е место по ущербу, наносимому болезнями в глобальном масштабе [12]. ОП является одним из основных сопутствующих за-болеваний при ХОБЛ [13,14], часто не диагностиру-ется [15] и ассоциируется с низким уровнем здоровья и плохим прогнозом [12]. По данным некоторых ис-следований, у больных ХОБЛ частота ОП может до-стигать 60 %, причем по мере прогрессирования за-болевания ОП выявляется чаще [16,17].…”