COPD and Risk of CV Morbidity and Mortality
Chronic obstructive pulmonary disease (COPD) and other disorders associated with reduced lung function are strong risk factors for cardiovascular events, independent of smoking.While the mechanism(s) for this observation is/are largely unknown, there is evidence that suggests that low-grade, systemic inflammation related to COPD may play an important role. In a severity-dependent fashion, circulating levels of C-reactive protein, fibrinogen, and other inflammatory biomarkers are 1.5-3.0 times higher among individuals with COPD than in those without. Importantly, COPD patients with elevated C-reactive protein and other inflammatory biomarkers have a higher risk of cardiac injury than those with normal C-reactive protein levels.The risk of cardiovascular events may be further amplified by the use of bronchodilators that adversely alter the delicate balance of sympathetic and parasympathetic forces within the autonomic nervous system. In sum, COPD is a risk factor for cardiovascular diseases. Persistent systemic inflammation may, in part, be responsible for this relationship.
Chronic obstructive pulmonary disease (COPD) affects more than 5% of the adult population and is the only major cause of death in the United States in which morbidity and mortality are increasing. By the year 2020, it is estimated that COPD will be the third leading cause of death and the fifth leading cause of disability worldwide. Although these figures are alarming, they most certainly underestimate the true health burdens of COPD, as airflow obstruction is an important contributor to other common causes of morbidity and mortality, including ischemic heart disease, arrhythmias, and stroke. The potential link between COPD and cardiovascular events has large clinical relevance because ischemic heart disease is the leading cause of mortality among patients with mild to moderate COPD. This article reviews the epidemiologic data, evaluating the relationship between poor lung function and cardiovascular morbidity and mortality and the potential mechanism(s) involved in this process.
Chronic obstructive pulmonary disease (COPD) and other disorders associated with reduced lung function are strong risk factors for cardiovascular events, independent of smoking.While the mechanism(s) for this observation is/are largely unknown, there is evidence that suggests that low-grade, systemic inflammation related to COPD may play an important role. In a severity-dependent fashion, circulating levels of C-reactive protein, fibrinogen, and other inflammatory biomarkers are 1.5-3.0 times higher among individuals with COPD than in those without. Importantly, COPD patients with elevated C-reactive protein and other inflammatory biomarkers have a higher risk of cardiac injury than those with normal C-reactive protein levels.The risk of cardiovascular events may be further amplified by the use of bronchodilators that adversely alter the delicate balance of sympathetic and parasympathetic forces within the autonomic nervous system. In sum, COPD is a risk factor for cardiovascular diseases. Persistent systemic inflammation may, in part, be responsible for this relationship.
Chronic obstructive pulmonary disease (COPD) affects more than 5% of the adult population and is the only major cause of death in the United States in which morbidity and mortality are increasing. By the year 2020, it is estimated that COPD will be the third leading cause of death and the fifth leading cause of disability worldwide. Although these figures are alarming, they most certainly underestimate the true health burdens of COPD, as airflow obstruction is an important contributor to other common causes of morbidity and mortality, including ischemic heart disease, arrhythmias, and stroke. The potential link between COPD and cardiovascular events has large clinical relevance because ischemic heart disease is the leading cause of mortality among patients with mild to moderate COPD. This article reviews the epidemiologic data, evaluating the relationship between poor lung function and cardiovascular morbidity and mortality and the potential mechanism(s) involved in this process.
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