title: Heart failure and chronic obstructive pulmonary disease: the challenges facing physicians and health services.
abstract: Pulmonary disease is common in patients with heart failure, through shared risk factors and pathophysiological mechanisms. Adverse pulmonary vascular remodelling and chronic systemic inflammation characterize both diseases. Concurrent chronic obstructive pulmonary disease presents diagnostic and therapeutic challenges, and is associated with increased morbidity and mortality. The cornerstones of therapy are beta-blockers and beta-agonists, whose pharmacological properties are diametrically opposed. Each disease is implicated in exacerbations of the other condition, greatly increasing hospitalizations and associated health care costs. Such multimorbidity is a key challenge for health-care systems oriented towards the treatment of individual diseases. Early identification and treatment of cardiopulmonary disease may alleviate this burden. However, diagnostic and therapeutic strategies require further validation in patients with both conditions.
authors.affiliation: Institute of Cardiovascular Medicine and Science, Liverpool Heart and Chest Hospital, Thomas Drive, Liverpool L14 3PE, UK.
authors.forename: Nathaniel M
authors.initials: NM
authors.lastname: Hawkins
authors.forename: Sean
authors.initials: S
authors.lastname: Virani
authors.forename: Claudio
authors.initials: C
authors.lastname: Ceconi
mesh_terms: D000318:Adrenergic beta-Agonists / Q000627:therapeutic use; D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D003365:Costs and Cost Analysis; D003937:Diagnosis, Differential; D004359:Drug Therapy, Combination; D042241:Early Diagnosis; D004452:Echocardiography; D020022:Genetic Predisposition to Disease / Q000235:genetics; D006333:Heart Failure / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D006801:Humans; D045265:Natriuretic Peptides / Q000378:metabolism; D017410:Practice Guidelines as Topic; D011379:Prognosis; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D016032:Randomized Controlled Trials as Topic; D012129:Respiratory Function Tests; D012307:Risk Factors
chemical_list: D000318:Adrenergic beta-Agonists; D000319:Adrenergic beta-Antagonists; D045265:Natriuretic Peptides
keywords: Adrenergic beta-agonists; Adrenergic beta-antagonists; Chronic obstructive pulmonary disease; Heart failure