CHEST Guidelines-Cardiovascular-Risk-in-COPD

Cardiovascular-Risk-in-COPD_chest

Pdf Summary

The association between Chronic Obstructive Pulmonary Disease (COPD) and cardiovascular diseases is highly prevalent, raising significant concerns due to cardiovascular diseases being a leading cause of mortality in COPD patients. A key issue is determining whether this link is due to shared risk factors, such as smoking and obesity, or if COPD itself directly contributes to cardiovascular risk.<br /><br />In a study by Soumagne et al., published in CHEST, the arterial stiffness of COPD patients was assessed using aortic pulse wave velocity (aPWV), with findings indicating increased arterial stiffness in smokers with COPD but not in nonsmokers with COPD. This suggests that smoking, rather than COPD itself, is a primary factor in increased cardiovascular risk in these patients. Their results are supported by regression analysis and other studies highlighting smoking as a significant driver of cardiovascular comorbidities. This is consistent with observations of increased arterial stiffness in smokers with COPD compared to smokers without COPD.<br /><br />However, the relationship is complex. While Soumagne's study focuses on mild-to-moderate COPD, more severe cases may demonstrate a stronger direct link between COPD and cardiovascular disease due to factors like systemic inflammation, hypoxia, and reduced exercise tolerance. COPD may exacerbate arterial stiffness and cardiovascular risk, especially when compounded by smoking, as indicated by synergistic effects observed in cohorts studying hypertension and tobacco use.<br /><br />The study underscores significant public health messages: smoking cessation reduces mortality in COPD, and exercise could decrease arterial stiffness, thus lowering cardiovascular risk. Further research, particularly on severe COPD and long-term cardiovascular outcomes, is essential to clarify these associations and develop targeted interventions for at-risk COPD populations.

Keywords

COPD

cardiovascular diseases

smoking

arterial stiffness

aortic pulse wave velocity

mortality

systemic inflammation

public health

smoking cessation

exercise