Drugs

, Volume 77, Issue 7, pp 721–732 | Cite as

Management of Chronic Obstructive Pulmonary Disease in Patients with Cardiovascular Diseases

  • Mario Cazzola
  • Luigino Calzetta
  • Barbara Rinaldi
  • Clive Page
  • Giuseppe Rosano
  • Paola Rogliani
  • Maria Gabriella Matera
Leading Article

Abstract

Chronic obstructive pulmonary disease (COPD) and cardiovascular diseases often coexist. The mechanistic links between these two diseases are complex, multifactorial and not entirely understood, but they can influence the therapeutic approach. Therapy can be primarily directed towards treating the respiratory symptoms and reducing lung inflammation. Smoking cessation, bronchodilators and inhaled corticosteroids are central to this therapeutic approach. The underlying pathophysiological mechanisms that are responsible for the increased cardiovascular risk in COPD remain unclear, but might include arterial stiffness, inflammation and endothelial dysfunction as a consequence of systemic exposure to chemicals in cigarette smoke or airborne pollution. Therefore, it is plausible that treatment of cardiovascular co-morbidities might reduce morbidity and mortality in patients with COPD and, consequently, therapy of COPD should be shifted to the treatment of cardiovascular diseases and systemic inflammation. In support of this approach, early data suggest that patients with COPD treated with angiotensin-converting enzyme inhibitors, angiotensin II type 1 receptor blockers, statins, anti-platelet drugs or β-adrenoceptor blockers may have improved survival and reduced hospitalisation from acute exacerbations of COPD. In this review, the potential impact of traditional therapies for COPD that are centred on treating the lungs and newer strategies potentially able to affect and mitigate cardiovascular risks in patients with COPD are discussed.

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Copyright information

© Springer International Publishing Switzerland 2017

Authors and Affiliations

  • Mario Cazzola
    • 1
  • Luigino Calzetta
    • 1
  • Barbara Rinaldi
    • 2
  • Clive Page
    • 3
  • Giuseppe Rosano
    • 4
    • 5
  • Paola Rogliani
    • 1
  • Maria Gabriella Matera
    • 2
  1. 1.Department of Systems MedicineUniversity of Rome Tor VergataRomeItaly
  2. 2.Department of Experimental MedicineUniversity of Campania Luigi VanvitelliNaplesItaly
  3. 3.Sackler Institute of Pulmonary PharmacologyKing’s College LondonLondonUK
  4. 4.Cardiovascular and Cell Science Institute, St George’s Hospital NHS TrustUniversity of LondonLondonUK
  5. 5.Department of Medical SciencesIRCCS San RaffaeleRomeItaly

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