COPD and co-morbidities, with special emphasis on cardiovascular conditions.

The concept of COPD as a systemic disease has been widely accepted in the past several years. In parallel, it has been emphasised that COPD morbidity and mortality is strongly related to co-morbid conditions. This review summarises some recent studies showing that in patients with COPD, the prevalence of cardiac failure is manifested in 10%-46% of the patients, and that up to 40% of patients with cardiac failure show evidence of COPD, about half of them not earlier diagnosed. Recent data also show an increased risk for arteriosclerotic manifestations in COPD patients, and cardiac complications are common causes of death in COPD patients. Other manifestations of the metabolic syndrome, as diabetes, are also over-represented in patients. It is also a well-established fact that a low FEV(1) is a risk factor for cardiovascular diseases and events. Mechanistically, a systemic inflammation in COPD could be a link to cardiovascular events. COPD raises inflammatory parameters and local anti-inflammatory treatment seems to have a potential to decrease the systemic inflammation and also to decrease cardiovascular events.