[Cardiovascular comorbidity in COPD].
[Cardiovascular comorbidity in COPD].
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DOI：
10.1016/s0300-2896(09)72859-5
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发表时间：
2009-01-01
影响因子：
8
通讯作者：
Garcia, Miguel Angel Martinez
中科院分区：
文献类型：
--
作者：
Cataluna, Juan Jose Soler;Garcia, Miguel Angel Martinez
慢性阻塞性肺疾病（COPD）患者存在心血管改变并非偶然。吸烟是这两种疾病的危险因素，可以部分解释这种关联的强度;然而，有数据表明，其他决定因素，如全身炎症，氧化应激，低氧血症，内皮功能障碍甚至衰老也可能参与其中。两种疾病患者的预后更差。心血管疾病（CVD）导致COPD患者住院和死亡。大约每四名COPD患者中就有一名死于心血管原因。同样，COPD急性加重也会导致更多的心血管事件，与无COPD的对照组相比，CVD和COPD患者的死亡率甚至会增加。这些决定性因素强调，需要制定一个全面的观点，早期发现有风险的个人和使用适当的治疗措施。血管扩张剂、他汀类药物和β受体阻滞剂可改善COPD患者的发病率和死亡率，这可能是因为这些药物可最大限度地控制潜在的CVD。尽管如此，他汀类药物的抗肿瘤潜力可能令人感兴趣。吸入皮质类固醇，甚至一些支气管扩张剂也可以降低心血管疾病的发病率。这些数据来自观察性研究，应谨慎解释，但仍然足够有趣，足以证明西方世界两种最流行的慢性疾病COPD和CVD之间的相互作用引起的巨大兴趣。
The presence of cardiovascular alterations in patients with chronic obstructive pulmonary disease (COPD) is no coincidence. Smoking, a risk factor for both entities, could partly explain the strength of the association; however, there are data that suggest that other determining factors such as systemic inflammation, oxidative stress, hypoxemia, endothelial dysfunction and even aging could also be involved. Prognosis is worse in patients with both entities. Cardiovascular disease (CVD) contributes to hospitalization in patients with COPD and to mortality. Approximately one out of every four patients with COPD dies from cardiovascular causes. Equally, COPD exacerbation also leads to a greater number of cardiovascular events and an increase in mortality has even been found among patients with CVD and COPD compared with controls without COPD. These determining factors underline the need to develop a comprehensive view for the early detection of at-risk individuals and use of appropriate therapeutic measures. Vasodilators, statins and beta-blockers may improve morbidity and mortality in patients with COPD, possibly because these drugs maximize control of the underlying CVD. Nevertheless, the antiinflammatory potential of statins could be of interest. Inhaled corticosteroids and even some bronchodilators could also decrease cardiovascular morbidity. These data are from observational studies and should be interpreted with caution but are nevertheless sufficiently interesting to warrant the enormous interest aroused by the interaction between the two most prevalent chronic diseases in the western world, COPD and CVD.