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

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.

2008 ◽  
pp. 48-52
Author(s):  
E. V. Privalova ◽  
T. V. Vavilova ◽  
N. A. Kuzubova

The aim of this study was to investigate morphological and functional erythrocyte parameters in smokers with chronic obstructive pulmonary disease (COPD). We measured erythrocyte parameters (RBC, HGB, HCT, MCV, MCH, MCHC, RDW-SD) using the automatic hematological analyzer Sysmex XT-2000i. Sixty-nine patients participated in the study. The patients were divided into 3 groups: 34 patients with COPD (mean age 63 yrs, median smoking history 36 packyrs); 15 smokers without bronchial obstruction (mean age 56 yrs, median smoking history 28 packyrs) and 20 nonsmokers of the sane age without bronchial obstruction. Smokers with COPD and smokers without bronchial obstruction had significantly higher erythrocyte parameters compared to those of nonsmokers. Smokers demonstrated higher HGB level that could be as a compensatory reaction to nicotine-related preclinical hypoxia. Marked increase in RBC number and anisocytosis (RDW-SD) reflected the erythron activation in smokers with COPD. These results suggest that measurement of erythrocyte parameters could be useful to assess symptomatic erythrocytosis in COPD patients.


2020 ◽  
Vol 9 (8) ◽  
pp. 2670
Author(s):  
Keiji Oishi ◽  
Kazuto Matsunaga ◽  
Toshihiro Shirai ◽  
Keita Hirai ◽  
Yasuhiro Gon

Airway inflammation in chronic obstructive pulmonary disease (COPD) is typically thought to be driven by Type1 immune responses, while Type2 inflammation appears to be present in definite proportions in the stable state and during exacerbations. In fact, some COPD patients showed gene expression of Type2 inflammation in the airway, and this subset was associated with the inhaled corticosteroid (ICS) response. Interestingly enough, the relationship between COPD and diseases associated with Type2 inflammation from the perspective of impaired lung development is increasingly highlighted by recent epidemiologic studies on the origin of COPD. Therefore, many researchers have shown an interest in the prevalence and the role of existent Type2 biomarkers such as sputum and blood eosinophils, exhaled nitric oxide fraction, and atopy, not only in asthma but also in COPD. Although the evidence about Type2 biomarkers in COPD is inconsistent and less robust, Type2 biomarkers have shown some potential when analyzing various clinical outcomes or therapeutic response to ICS. In this article, we review the existent and emerging Type2 biomarkers with clinically higher applicability in the management of COPD.


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

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.


2019 ◽  
Vol 7 (14) ◽  
pp. 2298-2304
Author(s):  
Muhammad Ilyas ◽  
Agussalim Agussalim ◽  
Megawati Megawati ◽  
Nasrum Massi ◽  
Irawaty Djaharuddin ◽  
...  

Background: Chronic Obstructive Pulmonary Disease (COPD) is a chronic inflammatory disease and disturbed bacterial clearance. Vitamin D deficiency is sometimes observed in COPD patients and as significant roles in increasing inflammation of airway obstruction and systemic obstruction, increasing proinflammatory cytokine including TNF-α, reduction of bacterial clearance and increase exacerbation risk due to infection. Also, vitamin D plays significant roles in the metabolism of calcium and mineralization of bones and regulation system of immune. TNF-α also has essential roles in pathogenesis and inflammation of COPD.  Several studies that investigate the relationship between vitamin D level and serum TNF-α concentration in COPD patients are relatively uncommon, including in Indonesia. For that reason, this study aimed to assess the relationship between vitamin D level and TNF-α concentration in patients on the severity of the chronic obstructive pulmonary disease. Methods This study was a hospital-based descriptive cross-sectional study. Total samples were 50 COPD patients with the average age of older than 60 years during their enrollments at the Department of Pulmonology and Respiratory Medicine of the Dr.Wahidin Sudirohusodo General hospital  Makassar in September 2018-January 2019. All procedures of the present study were reviewed and approved by the Research Ethics Committee of Medicine Faculty of Hasanuddin University. The severity of COPD was assessed according to the combination of COPD assessment stages that referred to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) Guideline 2015 that consisted of the combination of scoring COPD Assessment Test (CAT), the modified Medical Research Council (mMRC) questionnaire and results of the spirometric measurement. Assessment of airway obstruction levels referred to the GOLD spirometric criteria. Determination of thoracic photographs was conducted to verify the COPD diagnosis of the severity of COPD. Determination of serum TNF-α concentration and vitamin D3 [1,25(OH)2D3] level used the ELISA method. Results  The majority of COPD patients were observed in the category of older than 60 years old accounted for 34 COPD patients (68%), and the majority of COPD patients were males accounted for 47 males with COPD (94%). The majority of COPD patients were observed in the group of D (38%). All the study subjects observed in this study were smokers, and 82% of them were in the category of heavy smokers. 21 study subjects had higher concentration of serum TNF-α  (tertile 3 = 0.21-1.83 pg/dl), 20 study subjects  and lower level of vitamin D (tertile 1 = 182.1-364.5 pg/dl). The majority of the study subjects (38%) were in the category of severe COPD (category D of the severity of COPD at the tertile 3) according to the GOLD Combine Assessment. In view of the relationship between vitamin D level and serum TNF-α concentration on the airway obstruction, there were significant positive correlations between the increase of vitamin D levels and the increase of serum TNF-α concentrations on airway obstruction. In view of the relationship between vitamin D level and serum TNF-α concentration on the severity of COPD, there were significant positive correlations between the increase of vitamin D levels (tertiles 1, 2 and 3) and the increase of serum TNF-α concentrations on the severity of COPD at p-value<0.05. Overall, there were non-linear relationships between vitamin D level and serum TNF-α concentration on the severity of COPD. Conclusions: Serum TNF-α concentration was positively associated with airway obstruction level and severity of COPD. Low level of vitamin D was negatively associated with airway obstruction level and severity of COPD. Vitamin D3 level (1,25(OH)2D) was negatively associated with serum TNF-α concentration and airway obstruction level and severity of COPD.


2017 ◽  
Vol 51 (10) ◽  
pp. 855-861 ◽  
Author(s):  
Damilola T. Adesanoye ◽  
Cynthia J. Willey

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.


2021 ◽  
Vol 10 (12) ◽  
pp. 2730
Author(s):  
Lorenzo Marinelli ◽  
Fabio Lanfranco ◽  
Giovanna Motta ◽  
Marco Zavattaro

Erectile dysfunction (ED) seems to be a widespread sexual issue in men affected by chronic obstructive pulmonary disease (COPD). Multiple causes appear to be involved such as hormonal imbalance, smoking habit, chronic inflammation, endothelial dysfunction, chronic hypoxia, psychiatric disorders (depression and anxiety), and medications. ED can have a significant impact on COPD men and consequently on their quality of life, which is usually already compromised. Given this situation, however, pneumologists usually do not properly care for the sexuality of COPD patients especially because men can be reluctant to talk about their intimate issues. The aim of this narrative review is to briefly summarize the evidence emerging from literature and to provide a wide point of view about sexual dysfunction in COPD men.


2021 ◽  
Vol 31 (1) ◽  
Author(s):  
Heling Bao ◽  
Guohua Jia ◽  
Shu Cong ◽  
Wanlu Sun ◽  
Jing Fan ◽  
...  

AbstractThis study aims to investigate the characteristics of the phenotype and management of chronic obstructive pulmonary disease (COPD) patients in the general population in China. We analyzed spirometry-confirmed COPD patients who were identified from a population-based, nationally representative sample in China. All participants were measured with airflow limitation severity based on post-bronchodilator FEV1 percent predicted, bronchodilator responsiveness, exacerbation history, and respiratory symptoms. Among a total of 9134 COPD patients, 90.3% were non-exacerbators, 2.9% were frequent exacerbators without chronic bronchitis, 2.0% were frequent exacerbators with chronic bronchitis, and 4.8% were asthma-COPD overlap. Less than 5% of non-exacerbators ever had pulmonary function testing performed. The utilization rate of inhaled medication in non-exacerbators, exacerbators without chronic bronchitis, exacerbators with chronic bronchitis, and asthma-COPD overlap was 1.4, 23.5, 29.5, and 19.4%, respectively. A comprehensive strategy for the management of COPD patients based on phenotype in primary care is urgently needed.


2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Kimberly Stephens Rudd ◽  
Tiffany Jackman

A literature review conducted, on the cost of Chronic Obstructive Pulmonary Disease (COPD) between patients who are compliant versus non-compliant, reflects on the data for the United States with an emphasis on the areas within the Florida Panhandle. An overview of costs associated with noncompliant COPD patients and strategies for encouraging patients to adhere to treatment and improve healthcare outcomes is provided. A review of recent peer-reviewed articles was performed to determine the additional costs associated with non-compliance. The direct cost of COPD was estimated at $6,246 per patient annually. Nationally projected expenditures for COPD were $49.9 billion in 2010, while costs in Florida were $2.5 billion. Florida’s costs for COPD management ranks much higher than the national average. Potential causes for the differentiation are associated with newer medications and devices that contribute to a higher out-of-pocket expense for patients, patient denial about the seriousness of their illness, and/or inability to understand compliance with treatment. The relationship between the primary care provider and COPD patient is critical for adherence to therapy.


2018 ◽  
Vol 3 (1) ◽  
pp. 17
Author(s):  
Katayoun Samadi ◽  
Shahram Kharabian ◽  
Atefeh Abedini ◽  
Foroogh Mohammadi ◽  
Azam Adeli ◽  
...  

Background: Sarcopenia is defined as loss of muscle mass with attendant loss of muscle strength and physical function and is associated with advancing age. Inflammatory condition of chronic disease leads to more rapid progression of this syndrome, which may adversely affect quality of life. The aim of this study was to determine the relationship between chronic obstructive pulmonary disease (COPD) and sarcopenia.Methods: This study included 108 COPD patients who were treated in the pulmonary clinic at Masih Daneshvari Hospital. Patients were categorized into three groups based on Global Initiative for Obstructive Lung Disease criteria. Sarcopenic parameters including muscle mass, muscle strength, and physical performance were measured by Bioimpedance Analysis, hand grip dynamometer, and the Short Physical Performance Battery test, respectively. According to the European Working Group on Sarcopenia in Older People cutoff points and the definition of sarcopenic obesity, sarcopenic patients were diagnosed and categorized based on different COPD severity scores.Results: The relationship between sarcopenia and COPD grading, which was assessed using multiple regression models with adjustment of confounding factors, including age, chronic diseases, and smoking, was statistically insignificant. However, by using forced expiratory volume in 1 second (FEV1) or ratio of FEV1 to forced vital capacity in this model, the results were significant (P = 0.026). A positive linear correlation was observed between skeletal muscle index (SMI) and spirometric data, which was assessed by Spearman’s correlation test. By exploring the association between sarcopenia and obesity with the one-way analysis of variance test, sarcopenic patients represented to have the minimal spirometric measures. However, this difference was only significant for actual measurements.Conclusion: This study showed that sarcopenic COPD patients had smaller spirometric measurements and that sarcopenia and magnitude of SMI were positively correlated with obstruction severity.


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