COPD and Cardiovascular Disease

Introduction:

Cardiovascular disease and COPD are frequently seen to occur together. According to some studies, people with COPD are more than twice as susceptible to cardiovascular disease than other people. Cigarette smoking, which is responsible for the cell-damaging process of inflammation, leads to both diseases, especially COPD. It can be managed with certain drug therapies, exercises, etc.

What Is COPD?

COPD or chronic obstructive pulmonary disease is a term used to describe diseases resulting in blocking the airflow and breathing-associated problems. These diseases are emphysema and chronic bronchitis. There is no definitive cure for COPD, and its symptoms can be managed. COPD comprises the following conditions.

Chronic Bronchitis:

Chronic bronchitis irritates the bronchial tubes, which transport air to and from the lungs. Due to this the tubes get swollen, and mucus deposits in the lining of the lungs. This accumulation leads to the narrowing of the tube's opening, making it hard to receive air into and out of the lungs.

Fine, hair-like structures on the inside of the bronchial tubes (cilia) eliminate mucus normally formed in the airways. However, the irritation caused due to chronic bronchitis or smoking causes destruction of the cilia. The destructed cilia are incapable of assisting in the clearance of mucus.

Emphysema:

Emphysema is the enlargement of the tiny air sacs (alveoli) permanently. These are present at the terminal end of the bronchial tubes at the bottom of the lungs. The structure of the lung is identical to an upside-down tree. The air sacs have a vital function in the transportation of oxygen and carbon dioxide into the blood. The damage occurred due to emphysema results in the destruction of the walls of the air sacs, making it difficult to obtain a full breath.

What Are the Symptoms of COPD?

The symptoms of COPD can be many. Some of them are

1. Dyspnea or shortness of breath, particularly while performing an activity.

2. Cough with thick, stringy mucus (phlegm), which might be clear or yellowish or normal cough.

3. Mostly, chest infections are seen.

4. Wheezing is observed frequently.

5. Chest heaviness.

What Is Cardiovascular Disease?

Cardiovascular disease (CVD) is a term incorporated to denote the conditions that affect the heart or blood vessels. It is frequently associated with the accumulation of fatty deposits inside the arteries (atherosclerosis) and an elevated risk of blood clotting. It can result in causing damage to the arteries of organs like the brain, heart, kidneys, and eyes. CVD can be of multiple types, frequently the types of CVD seen are:

Coronary Heart Disease

Coronary heart disease is seen when the flow of oxygen-rich (oxygenated) blood to the heart muscle becomes blocked or is decreased. This results in causing strain on the heart and can further result in:

• Angina- It is a condition in which chest pain occurs due to restricted flow of blood to the heart muscle.

• Heart Attacks – When the blood flow of blood to the heart muscle gets obstructed all of a sudden.

• Heart Failure – Where the heart becomes unable to pump enough blood around the body properly.

Stroke

A stroke is a condition in which the blood supply to part of the brain is cut off, which leads to brain damage and sometimes death. A transient ischaemic attack is also similar but in this condition, the blood flow to the brain is disrupted only temporarily.

Peripheral Arterial Disease

Peripheral arterial disease is a condition in which a blockage in the arteries of the limbs is seen, mostly the legs. This can lead to:

• The dull or cramping ache in the legs gets worse while walking and gets better with rest.

• Loss of hair on the legs and feet.

• Numbness or weakness is seen in the legs.

• Ulcers were seen persistently on the feet and legs.

Aortic Disease:

Aortic diseases are a group of diseases seen to affect the aorta. It is the largest blood vessel in the body, which is responsible for carrying blood from the heart to the entire body. One of the most frequently seen aortic diseases is an aortic aneurysm in which the aorta turns weak and bulges outwards.

What Is the Relation Between COPD and Cardiovascular Disease?

Cardiovascular disease and COPD are frequently seen to occur together. According to some studies, people with COPD are more than twice as susceptible to cardiovascular disease than other people. Cigarette smoking, which is responsible for the cell-damaging process of inflammation, leads to both diseases, especially COPD. Smoking (both past and present) accounts for at least 80 percent of COPD cases.

Chronic obstructive pulmonary disease (COPD) is regarded as one of the primary causes of mortality. Cardiovascular diseases are diagnosed frequently in COPD patients, not only due to the common risk factors these two diseases share but also due to the systemic inflammation that characterizes COPD and has deleterious effects on the cardiovascular system.

The comorbid cardiovascular diseases in COPD result in multiple problems in the holistic treatment of these patients and are likely to affect outcomes such as morbidity and mortality.

Various studies revealed that mortality from cardiovascular issues is frequent in COPD patients, while the risk for acute cardiovascular events elevates during COPD exacerbations and remains high for a long duration even after recovery. It is noted that the coexistence of COPD and CVD is associated with more complex inflammatory mechanisms, especially in patients under 65 years of age. The link between CVD and COPD has numerous additional biological processes, including hypoxia, systemic inflammation, endothelial dysfunction, increased platelet reactivity, and arterial stiffness.

How Is COPD Managed in Patients of CVD?

For the management, take the following steps:

1. Smoking cessation: It is crucial to improve outcomes in patients with comorbid COPD and CVD.

2. Inhaled drugs that relax the muscles around the airways, known as bronchodilators, are a mainstay of COPD therapy. Also, just as people with heart disease can benefit from cardiac rehabilitation, people with symptoms of COPD may benefit from pulmonary rehabilitation. The multifaceted program of aerobic exercise and strength training.

3. Indications for supplemental oxygen - Supplemental oxygen therapy is incorporated to correct hypoxemia, which is associated with stable COPD or a COPD exacerbation.

4. Inhaled anticholinergic agents, selective beta-2 agonists, and glucocorticoids.

Conclusion:

COPD and CVD are interlinked in many people. COPD is a lung disease in which a sufficient amount of oxygen does not reach the lungs. In CVD, insufficient blood flow to the heart takes place. Smoking is dangerous in both situations. To manage this condition one should quit smoking, start anticholinergic drugs, exercise, etc.