Medicus, Vol. 30 No. 2 Astma i KOPB, 2021.
Review article
Chronic Obstructive Pulmonary Disease and Comorbidities
Branislava Milenković
Sanja Dimić Janjić
Abstract
COPD very often coexist with comorbidities, usually sharing the same risk factors and negatively influencing other diseases. COPD and comorbidities are caused and worsened by inflammatory and oxidative mechanisms with prevalence ranging from 20% to 81%. Cardiovascular diseases (CD) have the highest incidence and potentially the highest risk of death, taking into account other comorbidities. Common pathophysiological mechanisms are endothelial dysfunction, pro-coagulant and pro-inflammatory conditions and obesity. The most common cardiovascular comorbidities are coronary heart disease, heart failure, arterial hypertension and peripheral vascular disease. Reduction in FEV1 increases the rate of coronary events
and mortality. Timely diagnosis of CD in COPD patients is necessary, as well as making diagnosis of COPD in patients with CD. Invasive and noninvasive assessment of CHD is often difficult in COPD patients because they exhibit respiratory limitations during exercise and stress. Arterial hypertension and peripheral vascular disease occur frequently in COPD patients due to endothelial dysfunction. Pulmonary function is negatively correlated with blood pressure in a healthy population and COPD patients. The prevalence of heart rhythm disorders is 12%– 14% in COPD patients and atrial fibrillation is the most common among them. Inhaled long-acting beta-2-agonists have an acceptable safety profile in cardiovascular patients. Osteoporosis is the major COPD comorbidity, which is often under-diagnosed and correlated with poor overall health status and COPD prognosis. Vitamin D deficiency relates to COPD and its comorbidities reducing innate and acquired immunity. Lung cancer, metabolic syndrome, obesity, malnutrition, depression, obstructive sleep apnea, muscle dysfunction and anemia are COPD comorbidities as well.
Keywords
COPD; comorbidity; cardiovascular diseases; osteoporosis; , vitamin D deficiency; obesity; lung cancer; depression
Hrčak ID:
264169
URI
Publication date:
18.10.2021.
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