[Chronic obstructive pulmonary disease and cardiovascular disease].
ABSTRACT In the last decade, various studies have suggested that chronic obstructive pulmonary disease (COPD) could favor the development of ischemic heart disease. Several observational and case-control studies have confirmed that patients with COPD have a higher risk of cardiovascular disorders. However, this increased risk could be largely explained by a greater prevalence of classical risk factors. Currently, there are no data to indicate a causal relation between COPD and cardiovascular disease and the concept of systemic inflammation as a common pathogenic mechanism has not been demonstrated. Equally, there is insufficient evidence to conclude that some drugs, such as statins or inhaled corticoids, could decrease cardiovascular risk in patients with COPD by reducing systemic inflammation. Currently, these drugs should only be recommended if patients show specific indications for their use.
- SourceAvailable from: nih.govCanadian Medical Association journal 04/1967; 96(12):811-2. · 7.27 Impact Factor
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ABSTRACT: This study delineates the effects of congestive heart failure on routine pulmonary function tests and assesses the changes in pulmonary function as congestive heart failure was treated. Twenty-eight patients had spirometry, lung volumes, and diffusing capacity measurements initially and at frequent intervals after their initial hospitalization for congestive heart failure. Initially the patients had both obstructive (mean forced expiratory volume in 1 s [FEV1], 48.2% +/- 13% predicted) and restrictive (mean forced vital capacity [FVC], 5.6% +/- 15.7% predicted) ventilatory dysfunction, but a normal carbon monoxide diffusing capacity. With treatment, pulmonary function rapidly improved initially and there was no further significant improvements in the mean pulmonary function after two weeks of treatment. However, there was marked interindividual variability and several patients took months to reach their best level of pulmonary function. Even with treatment, the patients retained evidence of obstructive ventilatory dysfunction and at the time of their best spirometry 53% (8/15) of nonsmokers still had an abnormally low FEV1/FVC ratio.Archives of Internal Medicine 04/1983; 143(3):429-33. · 11.46 Impact Factor
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ABSTRACT: An epidemiologic study was carried out to examine the possible role of beta-agonists and other respiratory medications in the development of idiopathic dilated cardiomyopathy. Associations with respiratory medications, bronchial asthma, emphysema, and chronic bronchitis were examined by comparing newly diagnosed cases (n = 129) ascertained from five Washington, DC, area hospitals for the period 1990-1992 with neighborhood controls (n = 258) identified by using a random digit dialing technique. The cases and controls were matched on sex and 5-year age intervals and were compared in the analysis using conditional logistic regression methods. A statistically significant association was observed between idiopathic dilated cardiomyopathy and history of emphysema or chronic bronchitis (adjusted odds ratio (OR) = 4.4, 95% confidence interval (CI) 1.6-12.4). The association with bronchial asthma was of borderline significance (adjusted OR = 1.9, 95% CI 0.9-4.2). Associations were also observed with use of oral beta-agonists (adjusted OR = 3.4, 95% CI 1.1-11.0) and beta-agonist inhalers or nebulization (adjusted OR = 3.2, 95% CI 1.4-7.1), as well as with use of oral corticosteroids, inhaled corticosteroids or cromolyn, and theophylline medications. A total of 20.0% (23 of 115) of the cases had a reported history of beta-agonist inhaler use compared with 6.7% (17 of 254) of the controls. The strength of these associations was diminished when the temporal relation between exposure to beta-agonist inhalers or oral preparations and clinical diagnosis of idiopathic dilated cardiomyopathy was taken into account, however, and the associations with duration of beta-agonist medication use were not statistically significant (p > 0.05). The results of this study suggest, but do not prove, that use of beta-agonists has an etiologic role in idiopathic dilated cardiomyopathy.American Journal of Epidemiology 09/1995; 142(4):395-403. · 4.78 Impact Factor