Cardiovascular disease and COPD
Ageing and smoking remain important shared risk factors for both cardiovascular disease (CVD) and Chronic Obstructive Pulmonary Disease (COPD). However, it is increasingly accepted that shared risk factors such as smoking are not the sole reason for the observed association between COPD and CVD, and COPD and CVD are more closely intertwined mechanistically than was previously thought. At the same time, our perceptions of COPD as a disease have changed. No longer considered ‘just a disease of the lungs’, COPD has recently been described as the pulmonary component of systematic endothelial disease whereby a range of inflammatory processes simultaneously affect multiple organs. This implies the presence of many other shared risk factors and common pathways between CVD and COPD. Further complicating this picture are the potentially direct effects between COPD on CVD. For example, acute exacerbations of COPD are shown to be associated with an increased risk of CVDs. CVDs are arguably the most important comorbidities for people with COPD. Not only are they common, their presence is associated with increased risk for hospitalization, longer length of stay, and mortality in COPD. The economic and humanistic burden associated with CVD in this population is considerable and the cumulative costs of treating comorbidities may even exceed that of treating COPD itself. The optimal management of CVD risk and outcomes (e.g., the CVD risk threshold that should invoke preventive therapies) in patients with COPD might differ from such management in the general non-COPD population. Reciprocally, optimal management of COPD (e.g., prevention of exacerbations) in presence of comorbid CVD might be different from the guideline-recommended management of COPD in the absence of CVD. This collection will include original research and systematic reviews covering basic science, translational and epidemiological research, as well as health outcomes and economics research around the broad topic of COPD and CVD. The focus is on ischaemic aspects (e.g. myocardial infarction and stroke) as well as heart failure. The issue will cover diagnostics, management, and the impact of concomitant CVD on the natural history of COPD (and vice versa). The management of COPD in presence of concomitant CVD, and CVD risk management in patients with COPD, are also of interest for this series.
Guest advisors
Jennifer Quint(Imperial College London, UK)
Jennifer is an Honorary Consultant Physician in Respiratory Medicine at both the Royal Brompton and Imperial College London NHS Foundation Trust. Prof Quint has used routinely collected electronic healthcare record data to study several respiratory diseases, including most recently COVID-19, as well as working to maximising the quality, linkage and usage of these data for clinical and research purposes.
Mohsen Sadatsafavi(The University of British Columbia, Canada)