Co-morbidities in people with COPD: a result of multiple diseases, or multiple manifestations of smoking and reactive inflammation?

There has been increased awareness and recognition of COPD in both developed and developing nations. As people with COPD are identified and treated before they reach end-stage lung disease, the multiple morbidities associated with COPD have been recognised. These morbidities affect many areas of the body and currently are often treated with numerous different drugs. This poly-pharmacy, and the need for therapy by multiple organ-specific specialists, is not optimal and often not feasible for patients with COPD. New information on many of the common multiple morbidities suggests that it may be possible to explain--and in the future control or treat--these multiple morbidities, by addressing one common trigger and a common final pathway of inflammation. This review outlines some of the reasons why it is time to consider a 'whole body' approach to COPD, rather than clinicians continuing to address the lungs first and then each additional organ one at a time.