Multidisciplinary Management of Patients With Chronic Obstructive Pulmonary Disease and Cardiovascular Disease
Arch Bronconeumol. 2024 Apr;60(4):226-237.
doi: 10.1016/j.arbres.2024.01.013.
Epub 2024 Feb 1.
[Article in
English,
Spanish]
Affiliations
- 1 Servicio de Neumología, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Universidad Complutense de Madrid, Madrid, Spain. Electronic address: javiermigueldiez@gmail.com.
- 2 Servicio de Cardiología, Hospital Clínico Universitario de Valencia, Valencia, Spain.
- 3 Servicio de Neumología, Hospital Universitario de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain.
- 4 Unidad de Insuficiencia Cardiaca y Trasplante Cardiaco, Hospital Universitario de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain.
- 5 Servicio de Neumología, Hospital Universitario Virgen de las Nieves, Granada, Spain.
- 6 Servicio de Cardiología e Instituto de Investigación i+12, Hospital Universitario 12 de Octubre, Madrid, Spain; Departamento de Medicina, UCM, CIBERCV, Madrid, Spain.
- 7 Servicio de Neumología, Hospital Arnau de Vilanova-Lliria, Valencia, Spain; Departamento de Medicina, Universitat de València, Valencia, Spain.
- 8 Servicio de Cardiología, Hospital Universitario Virgen de la Arrixaca, El Palmar, Murcia, Spain.
- 9 Servicio de Neumología, Hospital Universitario de Cruces, Barakaldo, Bizkaia, Spain.
- 10 Sección de Cardiología, Hospital Universitario Virgen de la Victoria, Málaga, Spain.
Abstract
Chronic obstructive pulmonary disease (COPD) and cardiovascular disease (CVD) frequently coexist, increasing the prevalence of both entities and impacting on symptoms and prognosis. CVD should be suspected in patients with COPD who have high/very high risk scores on validated scales, frequent exacerbations, precordial pain, disproportionate dyspnea, or palpitations. They should be referred to cardiology if they have palpitations of unknown cause or angina pain. COPD should be suspected in patients with CVD if they have recurrent bronchitis, cough and expectoration, or disproportionate dyspnea. They should be referred to a pulmonologist if they have rhonchi or wheezing, air trapping, emphysema, or signs of chronic bronchitis. Treatment of COPD in cardiovascular patients should include long-acting muscarinic receptor antagonists (LAMA) or long-acting beta-agonists (LABA) in low-risk or high-risk non-exacerbators, and LAMA/LABA/inhaled corticosteroids in exacerbators who are not controlled with bronchodilators. Cardioselective beta-blockers should be favored in patients with CVD, the long-term need for amiodarone should be assessed, and antiplatelet drugs should be maintained if indicated.
Keywords:
Cardiopulmonary risk; Cardiovascular disease; Chronic obstructive pulmonary disease; Comorbidities; Exacerbations.
Copyright © 2024 The Authors. Published by Elsevier España, S.L.U. All rights reserved.
MeSH terms
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Administration, Inhalation
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Adrenal Cortex Hormones / therapeutic use
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Adrenergic beta-2 Receptor Agonists / therapeutic use
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Bronchodilator Agents / therapeutic use
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Cardiovascular Diseases* / complications
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Drug Therapy, Combination
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Dyspnea
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Humans
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Muscarinic Antagonists / therapeutic use
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Pain / drug therapy
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Pulmonary Disease, Chronic Obstructive* / drug therapy
Substances
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Muscarinic Antagonists
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Adrenal Cortex Hormones
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Adrenergic beta-2 Receptor Agonists
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Bronchodilator Agents