Defining the relationship between COPD and CVD: what are the implications for clinical practice?

Abstract

Cardiovascular diseases (CVDs) are arguably the most important comorbidities in chronic obstructive pulmonary disease (COPD). CVDs are common in people with COPD, and their presence is associated with increased risk for hospitalization, longer length of stay and all-cause and CVD-related mortality. The economic burden associated with CVD in this population is considerable and the cumulative cost of treating comorbidities may even exceed that of treating COPD itself.Our understanding of the biological mechanisms that link COPD and various forms of CVD has improved significantly over the past decade. But despite broad acceptance of the prognostic significance of CVDs in COPD, there remains widespread under-recognition and undertreatment of comorbid CVD in this population. The reasons for this are unclear; however institutional barriers and a lack of evidence-based guidelines for the management of CVD in people with COPD may be contributory factors.In this review, we summarize current knowledge relating to the prevalence and incidence of CVD in people with COPD and the mechanisms that underlie their coexistence. We discuss the implications for clinical practice and highlight opportunities for improved prevention and treatment of CVD in people with COPD. While we advocate more active assessment for signs of cardiovascular conditions across all age groups and all stages of COPD severity, we suggest targeting those aged under 65 years. Evidence indicates that the increased risks for CVD are particularly pronounced in COPD patients in mid-to-late-middle-age and thus it is in this age group that the benefits of early intervention may prove to be the most effective.

Risk factors of chronic obstructive pulmonary disease exacerbations

“…They often associate ischemic heart disease, arrhythmias, heart failure and the arterial circulation diseases. The presence of CVDs in the COPD group is associated with increased likelihood of mortality, of unfavourable outcomes, a higher rate of hospitalisations and a low quality of life …”

“…The presence of CVDs in the COPD group is associated with increased likelihood of mortality, of unfavourable outcomes, a higher rate of hospitalisations and a low quality of life. 64,95 Heart failure may mimic AECOPD and the presence of this comorbidity is an independent predictor of mortality. Atrial fibrillation can be a consequence or a trigger of an AECOPD episode.…”

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

“…Cardiovascular diseases (CVDs) are arguably the most important comorbidities in COPD. CVDs are common in people with COPD, and their presence is associated with an increased risk for hospitalization, longer length of stay and all-cause and CVD-related mortality (5). The mechanisms that underlie the association between COPD and CVDs are not well understood, but several processes are thought to be important and may interact with each other.…”

Study on prevalence of left ventricular diastolic dysfunction in chronic obstructive pulmonary disease

“…Cardiovascular manifestations associated with COPD presence are ischemic heart disease, congestive heart failure, arrhythmias, most commonly atrial fibrillation (AF), etc. 6 COPD patients even in the absence of ischemic heart disease. 2 Hence the present study was done to assess the LVD function in COPD patients using echocardiogram and to detect the presence of LVD dysfunction in all stages of COPD (Global initiative for chronic obstructive lung disease-GLOBAL stages).…”