Does Cardiovascular Comorbidity Influence the Prescribing of Bronchodilators in Chronic Obstructive Pulmonary Disease?

2017 ◽  
Vol 51 (10) ◽  
pp. 855-861 ◽  
Author(s):  
Damilola T. Adesanoye ◽  
Cynthia J. Willey
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
High Risk Patient ◽  
Chronic Obstructive ◽  
Treatment Rate ◽  
Cross Sectional ◽  
Obstructive Pulmonary Disease ◽  
Specific Patient ◽  
Cardiovascular Comorbidity ◽  
Copd Patients

Background: Cardiovascular disease (CVD) is the most prevalent comorbidity for chronic obstructive pulmonary disease (COPD). Potential adverse cardiovascular events of bronchodilators warrant their cautionary use in the comorbid COPD-CVD population, yet little is known about the prescribing of bronchodilators in this high-risk patient group. Objective: To determine whether comorbid CVD is associated with reduced bronchodilator prescribing in patients with COPD. In addition, we explored how the association was modified by gender, concurrent asthma, and concomitant β-blocker (BB) use. Methods: A cross-sectional study was conducted using the 2010 National Ambulatory Medical Care Survey. All visits among diagnosed COPD patients 40 years and older were examined. Logistic regression on survey-weighted data was used to predict treatment with bronchodilators and determine the influence of gender, asthma, and BBs on bronchodilator prescribing. Results: Among 11 627 061 ambulatory COPD visits, we found a significantly lower bronchodilator treatment rate among patients with comorbid CVD (32.3%) than among patients without CVD (57.6%). The observed effect was modified by gender, asthma, and BBs. Deprescribing was more pronounced for females than males, for nonusers of BBs than users of BBs, and for asthma patients than nonasthma patients. CVD did not affect bronchodilator prescribing in either asthmatic or nonasthmatic males taking BBs. Conclusions: Most COPD patients with concurrent CVD were less likely to be prescribed bronchodilators, with the exception of males who were also prescribed BBs. Thus, this study highlights a specific patient subgroup for whom the guidelines are less likely to be observed.

scholarly journals Inhaler Technique and Adherence to Inhaled Medications among Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease in Vietnam

2019 ◽  
Vol 16 (2) ◽  
pp. 185 ◽  
Author(s):  
Chau Ngo ◽  
Dung Phan ◽  
Giap Vu ◽  
Phu Dao ◽  
Phuong Phan ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Medication Adherence ◽  
Pulmonary Disease ◽  
Associated Factors ◽  
Chronic Obstructive ◽  
Inhaler Technique ◽  
Linear Regression Models ◽  
Cross Sectional ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients

Sub-optimal chronic obstructive pulmonary disease (COPD) management has been found largely due to patients’ medication non-adherence and incorrect inhaler technique. This study aimed to examine inhaler use technique and medication adherence among Vietnamese COPD patients as well as potential associated factors. A cross-sectional study involving 70 COPD exacerbators was conducted. Inhaler technique and adherence were evaluated by the 10-item and 12-item Test of Adherence to Inhaler (TAI). Data on the history of COPD, home prescription of inhalers and duration of hospitalization were also collected. Generalized linear regression models were used to determine the associated factors with inhaler use and medication adherence. The results showed that the proportion of patients with good inhaler technique was 22.7% for metered-dose inhalers (MDI), 30.4% for dry powder inhalers (DPI) and 31.8% for soft-mist inhalers (SMI). Full exhalation was the most common mistake. The rates of non-compliance patterns were: “ignorant” (77.1%), “sporadic” (58.6%), and “deliberate” (55.7%). Worse dyspnea, greater health condition impairment, and an increased frequency of exacerbations and hospitalizations were found to be associated negatively with correct inhaler use and treatment adherence. Instructions to COPD patients about using inhalers should focus on correct inhaler technique and adherence even when feeling healthy.

scholarly journals CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD)

2016 ◽  
Vol 23 (09) ◽  
pp. 1073-1078
Author(s):  
Atif Sitwat Hayat ◽  
Abdul Haque Khan ◽  
Ghulam Nabi Pathan ◽  
Mohammad Zubair Mushtaque
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Cross Sectional Study ◽  
Chronic Obstructive ◽  
C Reactive Protein ◽  
Cross Sectional ◽  
Obstructive Pulmonary Disease ◽  
Reactive Protein ◽  
Copd Patients ◽  
Study Results

Objectives: Chronic obstructive pulmonary disease (COPD) leads to partialreversible obstruction of airways. The objective of our study is to determine frequency ofelevated C-reactive protein (CRP) level in patients of COPD at Liaquat University HospitalJamshoro/Hyderabad. Study Design: Cross-sectional study. Setting: Medical Unit-I of LiaquatUniversity Hospital Jamshoro/Hyderabad. Period: 1st March 2013 to 31st August 2013. Patientsand Methods: Patients of either sex and ages from 40-80 years old and having COPD for atleast two years duration were included. Patients below 40 years of age, having malignanciesor autoimmune disorders were excluded from this study. Results: We enrolled 186 patientswith COPD and their mean age was ± SD 57.63±8.45 years. Majority 182 (97.8%) had habitof smoking while 4(2.2%) were non-smokers. Mean CRP level in COPD patients was ± SD1.26±0.79 (range 0.1- 3.0 mg/d1). Out of 186 COPD patients, 94(50.6%) have raised CRP level(higher than 1.0 mg/dl). Median value of CRP level during this study was 1.10 mg/dl. About92(49.4%) patients have normal level of CRP (less than 1.0 mg/dl). Conclusion: On conclusion,frequency of raised C-reactive protein in our study was much higher (50.6%).

scholarly journals Study of Factors Associated with Sarcopenia in COPD Patients

2021 ◽  
Vol 33 (1) ◽  
pp. 50-53
Author(s):  
Saleh Ahmed
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Bioelectrical Impedance ◽  
Chronic Obstructive ◽  
College Hospital ◽  
Cross Sectional ◽  
Obstructive Pulmonary Disease ◽  
Factors Associated ◽  
Copd Patients ◽  
Severe Copd

Introduction: Sarcopenia is frequently associated with chronic diseases such as chronic obstructive pulmonary disease (COPD). Sarcopenia can be classified as physical frailty where frailty is associated with adverse health outcomes. Sarcopenia was found to be associated with worsening lung function in male COPD patient. Objective was to find out the factors associated with sarcopenia in COPD patients. Materials & Methods: This was cross-sectional observational study was carried out Different Privet Medical in Chandpur and Chandpur Medical College Hospital, Chandpur. Patients diagnosed with COPD according to Global Initiative for Chronic Obstructive Pulmonary Disease (GOLD) guidelines were included in this study. Exclusion criteria were unstable cardiac disease, an exacerbation within the preceding 4 weeks, predominant neurological limitation to walking (eg, significant hemiplegia) or contraindication to bioelectrical impedance analysis (BIA) including an implanted pacemaker or defibrillator. All participants gave written informed consent. EWGSOP criteria were applied to outpatients with stable COPD. Results: In uniavariate analysis, age, moderate COPD, severe COPD, obesity, non-elective admission over the past 12 months, MMRC scale and MAP were significantly associated with sarcopenia. In multivariate analysis, age, moderate COPD, severe COPD, obesity and MMRC scale were significantly associated with sarcopenia. Conclusion: Prevalence of sarcopenia was 26%. Independent factors associated with sarcopenia Age (>70 years) years (adjusted odds ratio (AOR) 4.387. Sarcopenia affects about one-quarter of COPD patients. Age, severity of COPD, MMRC scale, and BMI status were the factors associated with sarcopenia. Medicine Today 2021 Vol.33(1): 50-53

Association Between Interleukin-6 Blood Level and Chronic Obstructive Pulmonary Disease Severity

2020 ◽  
Vol 17 (7) ◽  
pp. 3097-3103
Author(s):  
Theopilus Obed Lay ◽  
Muhammad Amin
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Proinflammatory Cytokines ◽  
Interleukin 6 ◽  
Chronic Obstructive ◽  
Cross Sectional ◽  
Obstructive Pulmonary Disease ◽  
Severity Level ◽  
Copd Patients ◽  
Significant Difference

Chronic obstructive pulmonary disease (COPD) is known as a chronic inflammatory disease that not only occurs in the lung, but also affects the systemic. A continuous chronic inflammation in COPD patients will have an increased proinflammatory cytokines, both in COPD patients’ respiratory tract and blood. Interleukin-6 (IL-6) is one of proinflammatory cytokines that increases with COPD progression. IL-6 level examination in COPD patient’s blood as a systemic inflammation indicator is convenient and quick. The research aimed to measure IL-6 level in COPD patient’s serum, to determine COPD severity level, and to analyze correlation between IL-6 and severity level. The research is an observational analytic study using cross sectional design. The samples were 38 non-exacerbated COPD outpatients who visited Lung Unit at Dr. Soetomo Teaching Hospital, Surabaya, Indonesia and met inclusion and exclusion criteria. The study found no significant correlation between IL-6, COPD severity level, COPD obstruction, first forced expiratory volume (FEV1), and FEV1/forced vital capacity (FVC), with p > 0.05. There was a significant correlation between IL-6 level, body mass index (BMI), and COPD assessment test (CAT) score, with p < 0.05, while there was no significant difference of IL-6 level between high-risk and low-risk patients, with p = 0.066 (p > 0.05). Moreover, there was a significant difference of IL-6 level between group A and D, with p = 0.040 (p < 0.05). There were no significant correlation and difference between COPD severities, COPD obstruction, FEV1, FVC, FEV1/FEC ratio, smoking duration with stable IL-6.

scholarly journals Urinary incontinence in female patients with chronic obstructive pulmonary disease

2001 ◽  
Vol 57 (4) ◽  
pp. 29
Author(s):  
M. Papadopoulos ◽  
I. Muller ◽  
S. Cullen
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Urinary Incontinence ◽  
Stress Urinary Incontinence ◽  
Pulmonary Disease ◽  
Smoking History ◽  
Chronic Obstructive ◽  
P Value ◽  
Cross Sectional ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients

Background: Urinary incontinence has been experienced as a problem since 1500 BC. In the twentieth century it is still a major problem that remains a source of distress for many sufferers. A lack of literature regarding the prevalence  of stress urinary incontinence (SUI) amongst chronic obstructive pulmonary disease (COPD) patients lead to this studyObjective: To determine the prevalence of stress urinary incontinence in female COPD patients between the ages of 30 and 70 years.Methods: This cross-sectional study included 67 female COPD patients (aged 30-70 years) who were interviewed during a three month period. A structured COPD / incontinence questionnaire was used to obtain data. Statistical analysis of results included Fisher’s exact test and two-tailed t-tests. A p-value of < 0,05 was considered to be statistical significant.Results: The prevalence of SUI in female COPD patients was estimated as 82,1%. Smoking history was the only variable with a significant positive correlation regarding the patients presenting with SUI (p < 0,05). The proportion of smokers in the subjects presenting with SUI (SUI group - 29/55) is significantly higher than the subjects with no symptoms of SUI (normal group - 2/12).Discussion and Conclusion: The outcome of this study revealed a high prevalence of SUI in female COPD patients. Cigarette smoking, as the major contributing factor, revealed a strong statistical correlation between COPD and SUI.

scholarly journals Murine models of cardiovascular comorbidity in chronic obstructive pulmonary disease

2016 ◽  
Vol 310 (11) ◽  
pp. L1011-L1027 ◽  
Author(s):  
P. Padmini S.J. Khedoe ◽  
Patrick C.N. Rensen ◽  
Jimmy F.P. Berbée ◽  
Pieter S. Hiemstra
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Therapeutic Strategies ◽  
Chronic Obstructive ◽  
Murine Models ◽  
Obstructive Pulmonary Disease ◽  
Cardiovascular Comorbidity ◽  
Copd Patients ◽  
Increased Risk ◽  
New Treatments

Patients with chronic obstructive pulmonary disease (COPD) have an increased risk for cardiovascular disease (CVD). Currently, COPD patients with atherosclerosis (i.e., the most important underlying cause of CVD) receive COPD therapy complemented with standard CVD therapy. This may, however, not be the most optimal treatment. To investigate the link between COPD and atherosclerosis and to develop specific therapeutic strategies for COPD patients with atherosclerosis, a substantial number of preclinical studies using murine models have been performed. In this review, we summarize the currently used murine models of COPD and atherosclerosis, both individually and combined, and discuss the relevance of these models for studying the pathogenesis and development of new treatments for COPD patients with atherosclerosis. Murine and clinical studies have provided complementary information showing a prominent role for systemic inflammation and oxidative stress in the link between COPD and atherosclerosis. These and other studies showed that murine models for COPD and atherosclerosis are useful tools and can provide important insights relevant to understanding the link between COPD and CVD. More importantly, murine studies provide good platforms for studying the potential of promising (new) therapeutic strategies for COPD patients with CVD.

scholarly journals Activities of daily living in patients with chronic obstructive pulmonary disease with depressive symptoms

2020 ◽  
Vol 27 (2) ◽  
pp. 194-201
Author(s):  
Rilda Carla Alves de Souza ◽  
Fabíola Cássia de Oliveira Silva Vieira ◽  
Graziella Monicky Oliveira Costa ◽  
Kamila Roberta Perpétua de Souza ◽  
Laura Maria Gomes de Siqueira ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Depressive Symptoms ◽  
Activities Of Daily Living ◽  
Pulmonary Disease ◽  
Daily Living ◽  
Cross Sectional Study ◽  
Chronic Obstructive ◽  
Cross Sectional ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients

ABSTRACT This cross-sectional study assessed the activities of daily living (ADL) and risk factors for developing depressive symptoms in patients with chronic obstructive pulmonary disease (COPD) and was carried out at the pulmonology outpatient clinic of the Hospital Universitário Oswaldo Cruz. Two hundred two (202) patients with COPD participated in the study. We evaluated the sociodemographic and anthropometric data, the ADL by means of Pulmonary Functional Status and Dyspnea Questionnaire - Modified version (PFSDQ-M), and the presence of depressive symptoms using the Beck Depression Inventory (BDI). All domains (dyspnea, fatigue and activity changes) of PFSDQ are compromised in patients with depressive symptoms. The prevalence of depressive symptoms was 38.6%. The chance of developing these symptoms was higher for those who used more than one bronchodilator (OR: 2.82, CI 95%: 1.47-5.38, p=0.002), presented dyslipidemias (OR: 2.74, CI95%: 1.24-6.07, p=0.012), had a heart disease (OR: 2.82, CI 95%: 1.18-6.74, p=0.020), presented expectoration (OR: 2.44, CI 95%: 1.2-4.95, p=0.014) or did not have a partner (OR: 2.58, CI 95%: 1.36-4.9, p=0.004). COPD patients with depressive symptoms had all domains of ADL compromised compared to patients without these symptoms.

scholarly journals Evaluating serum C-reactive protein level in patients with chronic obstructive pulmonary disease – A cross-sectional study

2019 ◽  
pp. 1-4
Author(s):  
Karthika M ◽  
Prakash Chandra Bhardwaj ◽  
Laimayum Amarnath Sharma ◽  
Laimayum Amarnath Sharma ◽  
W Kanan ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Cross Sectional Study ◽  
Chronic Obstructive ◽  
C Reactive Protein ◽  
Cross Sectional ◽  
Obstructive Pulmonary Disease ◽  
Reactive Protein ◽  
Copd Patients ◽  
Serum Crp

Abstract Patients with the chronic obstructive pulmonary disease have ongoing systemic inflammation, which can be assessed by measuring serum  C- reactive protein. Objective: To explore whether CRP could be used as an independent predictor of disease outcome in COPD. Methods: A cross-sectional study was conducted among 50 COPD patients attending Respiratory Medicine outpatient services in the Regional Institute of Medical Sciences (RIMS), Imphal from January 2015 to September 2016. Patients aged 18-67 were included in the study after obtaining Ethical approval from the Research Ethics Board, RIMS, Imphal. Computerized Spirometer Helios 401 was the instrument used to measure lung volumes and capacities. BeneSpheraTM CRP Latex Slide test kit was used to estimate serum c-reactive protein. Results and observation: The present study was conducted on fifty COPD patients in which serum CRP level showed positive correlation with COPD (p=0.002) but serum CRP level with spirometric parameters showed significant negative correlation;FEV1 (r=-0.451, p=0.001), FEV1/FVC (r=-0.617, p<0.001) and PEFR (r=-0.398, p=0.004). Conclusion: In our study, we found an association between serum CRP level and severity of COPD and Plasma CRP may be used as a marker of prognosis in COPD as the small increase is associated with poorer prognosis in COPD. Keywords: CRP; Chronic obstructive pulmonary disease (COPD); Imphal.

scholarly journals Chronic obstructive pulmonary disease and cardiovascular comorbidity

Kardiologiia ◽  
2019 ◽  
Vol 59 (8S) ◽  
pp. 24-36 ◽  
Author(s):  
Z. R. Aisanov ◽  
A. G. Chuchalin ◽  
E. N. Kalmanova
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
General Population ◽  
Pulmonary Disease ◽  
Point Of View ◽  
Chronic Obstructive ◽  
Bronchial Obstruction ◽  
Obstructive Pulmonary Disease ◽  
Cardiovascular Comorbidity ◽  
Copd Patients ◽  
The Relationship

In recent years, a greater understanding of the heterogeneity and complexity of chronic obstructive pulmonary disease (COPD) has come from the point of view of an integrated clinical assessment of severity, pathophysiology, and the relationship with other pathologies. A typical COPD patient suffers on average 4 or more concomitant diseases and every day about a third of patients take from 5 to 10 different drugs. The mechanisms of the interaction of COPD and cardiovascular disease (CVD) include the effects of systemic inflammation, hyperinflation (hyperinflation) of the lungs and bronchial obstruction. The risk of developing CVD in patients with COPD is on average 2–3 times higher than in people of a comparable age in the general population, even taking into account the risk of smoking. The prevalence of coronary heart disease, heart failure, and rhythm disturbances among COPD patients is significantly higher than in the general population. The article discusses in detail the safety of prescribing various groups of drugs for the treatment of CVD in patients with COPD. Achieving success in understanding and managing patients with COPD and CVD is possible using an integrated multidisciplinary approach.

scholarly journals Echocardiographic Right Heart Study in Patients with Chronic Obstructive Pulmonary Disease

2021 ◽  
Vol 33 (2) ◽  
pp. 123-128
Author(s):  
Kazi Shamim Al Mamun ◽  
Mohammad Ibrahim Chowdhury ◽  
Muhammad Khurshed Alam ◽  
Syedul Alam Khuryshi ◽  
SM Ifteakharul Islam
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Hypertension ◽  
Pulmonary Disease ◽  
Chronic Obstructive ◽  
Rapid Progression ◽  
Right Heart ◽  
Cross Sectional ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
The Right

Introduction: Chronic obstructive pulmonary disease (COPD) has considerable effects on cardiac functions, including those of the right ventricle, left ventricle, and pulmonary blood vessels. Most of the increased mortality associated with COPD is due to cardiac involvement. Echocardiography provides a rapid, noninvasive, portable, and accurate method to evaluate the cardiac changes. Aims: We aimed to prospectively study the patients with diagnosed COPD with echocardiogram for evaluating the right heart. Materials & Methods: Our study was an observational, cross sectional study was done on 50 patients with COPD who were admitted at Department of Cardiology, CMCH and underwent echocardiographic evaluation from November 2017 –October 2018. All echocardiogaphic parameters focused on right heart and its function were assessed. Results: Out of total 50 COPD patients studied, majority of them were male (46 patients ,92%). The mean age group of the studied patients was 58.4 ±7.7 years. Pulmonary hypertension defined as sPAP>30 mmHg was evident in all of the patients; with 30 patients (60%), 14 (28 %) and 6(12 %) patients having severe, moderate and mild pulmonary hypertension respectively. RV dysfunction was evident with reduced average TAPSE values (1.59± 0.38 cm) and elevated RIMP values (0.58±0.16). Conclusion: Majority of COPD patients had evidence of pulmonary hypertension. Echocardiogram can be a helpful tool to assess early changes on the right heart size and function in patients with COPD and also monitor these patients for rapid progression of the illness. Medicine Today 2021 Vol.33(2): 123-128

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