Chronic obstructive pulmonary disease and cardiovascular co-morbidities

Abstract

BACKGROUND Chronic Obstructive Pulmonary Disease (COPD) is the fourth largest cause of death worldwide. However, most patients with COPD die from cardiovascular causes (CVD). COPD is an independent risk factor for CVD and a predictor of long-term mortality. There is a high prevalence of traditional risk factors in this patient group, including smoking, sedentary behaviour and low socio-economic class. COPD is now recognized to having both local lung and systemic effects. The mechanism of such systemic effects is not completely known, but it is supposed to be related to enhanced systemic inflammation and to oxidative stress, both implicated in the pathogenesis of atherosclerotic process. CONCLUSIONS COPD is frequently associated with congestive heart failure (CHF). It is also a confounding factor for the diagnosis of CHF. In fact, some studies demonstrate that about 20% of patients diagnosed with COPD had also or only CHF. Patients with CHF and associated COPD have less frequently β-blockers prescription than CHF patients without COPD. COPD is a heavy negative prognostic factor for CHF hospitalization and mortality. Pulmonary Embolism (PE) in patients with COPD is generally underdiagnosed, and this last disease is a risk factor for a complicated course of PE, with increased mortality.