Cardiovascular Comorbidities of COPD: When Do they Occur and How are they Managed?
Angelos Angelakas, Charalambos Vlachopoulos, Nikolaos Ioakeimidis, Athanasios Aggelis, Konstantinos Aznaouridis and Christodoulos Stefanadis
Affiliation: 1st Cardiology Department, Athens Medical School, Hippokration Hospital, 60, Vatatzi Street, 11473 Athens, Greece.
Keywords: cardiac arrhythmias, cerebrovascular disease, chronic obstructive pulmonary disease, congestive heart failure,
coronary artery disease, pulmonary hypertension, peripheral artery disease.
Chronic obstructive pulmonary disease (COPD) is highly prevalent worldwide. Its morbidity and mortality are
increasing and it is predicted to be the third leading cause of death by 2020. COPD and cardiovascular disease (CVD) are
chronic conditions that share many risk factors and a complex pathophysiology. Current literature has closely focused on
the relationship between these two diseases and today COPD is considered to be an independent risk factor for CVD,
which is the leading cause of death in approximately 50% of COPD patients. Coronary artery disease, congestive heart
failure, pulmonary hypertension, cardiac arrhythmias, peripheral artery and cerebrovascular disease have been
documented to present more frequently in COPD patients than in individuals without COPD. Moreover, despite the fact
that the exact pathophysiologic mechanism linking COPD to CVD is not yet found, systemic inflammation is one of the
most likely protagonists of this connection, as atherosclerosis is directly associated with inflammation. Finally, the aim of
this review is to assess the prevalence of cardiovascular comorbidities on COPD patients, to detect the possible
pathophysiological mechanisms and to discuss the available therapeutic options aimed at managing these comorbidities
and reducing the COPD associated cardiovascular risk.
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