Jeanette P Brown1, Carlos H Martinez. 1. Division of Pulmonary and Critical Care Medicine, University of Michigan Health System, Ann Arbor, Michigan, USA.
Abstract
PURPOSE OF REVIEW: Classic descriptions of chronic obstructive pulmonary disease (COPD) centered on its impact on respiratory function. It is currently recognized that comorbidities contribute to the severity of symptoms and COPD progression. Understanding COPD-comorbidities associations could provide innovative treatment strategies and identify new mechanistic pathways to be targeted. RECENT FINDINGS: Some comorbidities are clustered with specific COPD phenotypes. There are stronger associations between airway-predominant disease and cardio-metabolic comorbidities, whereas in emphysema-predominant COPD sarcopenia and osteoporosis are frequent. These patterns suggest different inflammatory pathways acting by COPD phenotype. Osteoporosis is a major concern in COPD, particularly among men. Although β-blockers use for cardiac indications in COPD remains low, recent evidence suggests that this medication group could decrease COPD exacerbations. Gastroesophageal reflux is consistently associated with poor COPD outcomes, but mechanisms and impact of treatment are still unclear. Nontraditional comorbid conditions, such as cognitive impairment, anxiety, and depression have significant impact in COPD outcomes. SUMMARY: Clinicians should screen their COPD patients for the presence of cardiovascular disease, diabetes, osteoporosis, sleep apnea, and sarcopenia, comorbidities for which specific treatments are available and associated with better COPD outcomes. The impact of interventions to treat gastroesophageal reflux disease, anxiety and depression is still to be defined.
PURPOSE OF REVIEW: Classic descriptions of chronic obstructive pulmonary disease (COPD) centered on its impact on respiratory function. It is currently recognized that comorbidities contribute to the severity of symptoms and COPD progression. Understanding COPD-comorbidities associations could provide innovative treatment strategies and identify new mechanistic pathways to be targeted. RECENT FINDINGS: Some comorbidities are clustered with specific COPD phenotypes. There are stronger associations between airway-predominant disease and cardio-metabolic comorbidities, whereas in emphysema-predominant COPD sarcopenia and osteoporosis are frequent. These patterns suggest different inflammatory pathways acting by COPD phenotype. Osteoporosis is a major concern in COPD, particularly among men. Although β-blockers use for cardiac indications in COPD remains low, recent evidence suggests that this medication group could decrease COPD exacerbations. Gastroesophageal reflux is consistently associated with poor COPD outcomes, but mechanisms and impact of treatment are still unclear. Nontraditional comorbid conditions, such as cognitive impairment, anxiety, and depression have significant impact in COPD outcomes. SUMMARY: Clinicians should screen their COPDpatients for the presence of cardiovascular disease, diabetes, osteoporosis, sleep apnea, and sarcopenia, comorbidities for which specific treatments are available and associated with better COPD outcomes. The impact of interventions to treat gastroesophageal reflux disease, anxiety and depression is still to be defined.
Authors: Michael Schivo; Timothy E Albertson; Angela Haczku; Nicholas J Kenyon; Amir A Zeki; Brooks T Kuhn; Samuel Louie; Mark V Avdalovic Journal: J Investig Med Date: 2017-03-03 Impact factor: 2.895
Authors: Carlos H Martinez; Alejandro A Diaz; Catherine A Meldrum; Merry-Lynn N McDonald; Susan Murray; Gregory L Kinney; John E Hokanson; Jeffrey L Curtis; Russell P Bowler; MeiLan K Han; George R Washko; Elizabeth A Regan Journal: Ann Am Thorac Soc Date: 2017-11
Authors: Ka Pang Chan; Fanny Ws Ko; Hok Sum Chan; Mo Lin Wong; Thomas Yw Mok; Kah Lin Choo; David Sc Hui Journal: Int J Chron Obstruct Pulmon Dis Date: 2017-11-28
Authors: Bruna S de Alencar Silva; Fábio S Lira; Fabrício E Rossi; Dionei Ramos; Juliana S Uzeloto; Ana P C F Freire; Fabiano F de Lima; Luís A Gobbo; Ercy M C Ramos Journal: Front Physiol Date: 2018-03-23 Impact factor: 4.566
Authors: Hok Sum Chan; Fanny Wai San Ko; Johnny Wai Man Chan; Loletta Kit Ying So; David Chi Leung Lam; Veronica Lee Chan; Cheuk Yin Tam; Wai Cho Yu Journal: Int J Chron Obstruct Pulmon Dis Date: 2018-06-13