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Identification and management of cardiopulmonary risk in patients with chronic obstructive pulmonary disease: a
Chris P Gale1,2,3, John R Hurst4, Nathaniel M Hawkins5
1Department of Cardiology, Leeds Teaching Hospitals NHS Trust, Leeds, UK.
Insights
Cardiovascular disease is common in chronic obstructive pulmonary disease (COPD) but often underdiagnosed and undertreated. Assessing and managing cardiopulmonary risk in COPD patients is crucial for better outcomes.
Area of Science:
- Pulmonology
- Cardiology
- Public Health
Background:
- Cardiovascular disease (CVD) frequently co-occurs with chronic obstructive pulmonary disease (COPD).
- CVD and associated risks are often underdiagnosed and undertreated in COPD patients.
- This underdiagnosis and undertreatment increases the risk of cardiopulmonary events.
Purpose of the Study:
- To develop a consensus statement on identifying and managing cardiopulmonary risk in COPD patients.
- To provide guidance for healthcare professionals on assessing and managing cardiovascular risk in the context of COPD.
- To improve cardiopulmonary outcomes by addressing the unmet public health need.
Main Methods:
- A Global Working Group of COPD and cardiovascular disease experts was convened.
- A consensus statement was drafted and refined through virtual meetings and remote collaboration.
- The modified Delphi method was used to finalize the consensus statement and key recommendations.
Main Results:
- A consensus statement emphasizes the importance of assessing and managing cardiopulmonary risk in COPD.
- Patients with COPD risk factors or disease should undergo spirometry to confirm COPD.
- Management of prevalent and incident cardiovascular diseases (heart failure, dyslipidemia, hypertension, ischemic heart disease, atrial fibrillation) in COPD should follow clinical guidelines.
- Reducing COPD exacerbation risk is vital for mitigating cardiopulmonary risk.
- Enhanced collaboration between cardiology, pulmonology, and primary care specialists is recommended.
Conclusions:
- Identifying and managing cardiopulmonary risk in COPD is a critical unmet public health need.
- Multidisciplinary collaboration and shared understanding are essential for improving cardiopulmonary outcomes in COPD patients.
Aims:
Cardiovascular disease is a common comorbidity in chronic obstructive pulmonary disease. Yet, cardiovascular disease and risk are underdiagnosed in chronic obstructive pulmonary disease and are often undertreated, increasing the risk of cardiopulmonary events.
Methods And Results:
We formed a Global Working Group of experts in chronic obstructive pulmonary disease and cardiovascular disease to produce a consensus statement detailing the identification and management of cardiopulmonary risk in patients with chronic obstructive pulmonary disease. We conducted virtual meetings supplemented by remote working and communication. The Chairs (C.P.G., M.B.) proposed a draft consensus statement, which was further developed by the Global Working Group. The selection of the final consensus statement and key points were obtained using the modified Delphi method. The consensus statement is, 'Given the high burden of fatal and non-fatal major cardiovascular and respiratory events in patients with COPD it is important that cardiopulmonary risk is assessed and managed'. Patients with cardiovascular risk factors or disease who have regular cough or expectoration, recurrent 'chest infections', a significant smoking history, or dyspnoea should complete spirometry to confirm the presence of chronic obstructive pulmonary disease. Prevalent and incident cardiovascular disease and risk in patients with chronic obstructive pulmonary disease, including heart failure, dyslipidaemia, hypertension, ischaemic heart disease, and atrial fibrillation, should be managed according to clinical guidelines. In addition, chronic obstructive pulmonary disease exacerbation risk in patients with chronic obstructive pulmonary disease should be addressed to reduce cardiopulmonary risk. Enhanced integration with specialists in cardiology, pulmonology, and primary care is recommended.
Conclusion:
The identification and management of cardiopulmonary risk in patients with chronic obstructive pulmonary disease are an unmet public health need that can be addressed through shared understanding and multidisciplinary working to improve cardiopulmonary outcomes.
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Symptoms of COPD can be classified as primary or systemic. Primary symptoms relate to reduced airflow, while systemic or extrapulmonary symptoms relate to COPD's broader impact on the body.
Primary Symptoms of COPD: