COPD and cardiovascular disease

Two recent offerings from the medical literature suggest an association between COPD and cardiovascular disease that may be under-appreciated. In this study from Chest patients with COPD had twice the rate of hospitalization for a composite of cardiovascular outcomes, adjusted for pre-study cardiovascular risk factors. The follow up period was just under three years.

This paper from the European Heart Journal reports unrecognized heart failure in 20% of patients with stable COPD. Approximately half the heart failure cases had systolic left ventricular dysfunction and half had primarily diastolic dysfunction. Surprisingly, none had right sided heart failure. The authors suggest that right sided failure is characteristic of more advanced COPD than was represented in this study. The reasons for the association may be both physiologic (e.g. ventricular interdependence) and epidemiologic (overlapping risk factors, particularly smoking).