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Management of the patient with severe COPD and cardiovascular disease

Authors
Imre Noth, MD
Gregory A Schmidt, MD
Section Editors
James K Stoller, MD, MS
Juan Carlos Kaski, DSc, MD, DM (Hons), FRCP, FESC, FACC, FAHA
Deputy Editors
Helen Hollingsworth, MD
Gordon M Saperia, MD, FACC

INTRODUCTION

Chronic obstructive pulmonary disease (COPD) and cardiovascular disease (CVD), which includes coronary heart disease, peripheral artery disease, and cerebrovascular disease, share tobacco abuse as a major risk factor. Thus, these two disorders commonly coexist. In addition, CVD is a leading cause of death among patients with COPD.

The management of patients with severe COPD and CVD will be reviewed here. The diagnosis and management of COPD and coronary heart disease occurring independently are discussed separately. (See "Chronic obstructive pulmonary disease: Definition, clinical manifestations, diagnosis, and staging" and "Management of stable chronic obstructive pulmonary disease" and "Management of exacerbations of chronic obstructive pulmonary disease" and "Stable ischemic heart disease: Overview of care" and "Epidemiology of coronary heart disease" and "Screening for coronary heart disease".)

COPD/CVD RELATIONSHIP

Chronic obstructive pulmonary disease (COPD) and cardiovascular disease (CVD) frequently coexist, and the presence of one can affect outcomes in the other [1]. As symptoms can overlap, differentiating the relative contributions of these diseases to a given patient’s symptoms can be challenging.

Coexistence of COPD and CVD — The frequent coexistence of COPD and CVD has been observed in several studies [2-4]. As an example, a study from a large United Kingdom database of more than 1.2 million patients over age 35 identified almost 30,000 patients with COPD; these patients were nearly five times more likely to have cardiovascular disease than those without COPD [2]. In a separate study of 351 patients with advanced COPD, clinically significant coronary disease was identified by angiography in 60 percent and was occult in 53 percent [3].

Impact of co-morbid disease on outcomes — A large number of observational studies have found that the coexistence of COPD and cardiovascular disease has an important impact on clinical outcomes.

                        

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Literature review current through: Nov 2016. | This topic last updated: Tue May 17 00:00:00 GMT+00:00 2016.
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