Official websites use. Share sensitive information only on official, secure websites. E-mail: arnaud. By , chronic obstructive pulmonary disease COPD will be the third cause of mortality.
Extrapulmonary comorbidities influence the prognosis of patients with COPD. Tobacco smoking is a common risk factor for many comorbidities, including coronary heart disease, heart failure and lung cancer. Comorbidities such as pulmonary artery disease and malnutrition are directly caused by COPD, whereas others, such as systemic venous thromboembolism, anxiety, depression, osteoporosis, obesity, metabolic syndrome, diabetes, sleep disturbance and anaemia, have no evident physiopathological relationship with COPD.
The common ground between most of these extrapulmonary manifestations is chronic systemic inflammation. All of these diseases potentiate the morbidity of COPD, leading to increased hospitalisations and healthcare costs. They can frequently cause death, independently of respiratory failure. Comorbidities make the management of COPD difficult and need to be evaluated and treated adequately. All the studies conducted agree in predicting that both the morbidity and mortality burden of chronic obstructive pulmonary disease COPD is rising.
By , COPD is projected to cause over 6 million deaths annually worldwide, thus becoming the third leading cause of death in the world [ 1 ]. Our general understanding of the disease has greatly improved over the past 10 years. Epidemiological studies and large clinical trials have helped us to understand the importance of comorbidities [ 5 , 6 ].
This article reviews the major comorbidities encountered in patients with COPD. Vascular and heart diseases are among the most important comorbidities observed in COPD, because they have a direct impact on patient survival. The pathophysiological mechanisms underlying the vascular alterations observed in COPD appear to be mainly mediated by endothelial dysfunction and coagulopathy.
