title: Overview of the pharmacological challenges facing physicians in the management of patients with concomitant cardiovascular disease and chronic obstructive pulmonary disease.
abstract: Cardiovascular disease (CVD), including ischaemic heart disease (IHD) and heart failure (HF), and chronic obstructive pulmonary disease (COPD) are often concomitant because they share both risk factors (smoke) and pathological pathways (systemic inflammation). Cardiovascular disease and COPD association is increasing overtime. Several registries clearly showed a negative impact on the clinical outcome of the concomitant presence of CVD and COPD. Patients with CVD and COPD present an increased risk for myocardial infarction, HF, and hospital admission for acute exacerbation of COPD, with a negative impact on prognosis. To reduce the effect of this negative association, it is of paramount importance the pharmacological treatment with both cardiovascular and respiratory drugs, according to current guidelines. Nevertheless, several registries and studies showed that evidence-based drugs (both cardiovascular and respiratory) are often under administered in this subset of patients. In this overview, we summarize the available data regarding the use of cardiovascular drugs (antiplatelet agents, angiotensin converting enzyme inhibitors, β-blockers, and statins) in COPD patients, with or without concomitant IHD. Furthermore, we report advantages and disadvantages of respiratory drugs (β2 agonists, anti-cholinergics, and corticosteroids) administration in COPD patients with CVD.
authors.affiliation: Cardiovascular Institute, Azienda Ospedaliero-Universitaria S.Anna, Cona (FE), Italy LTTA Center, Ferrara, Italy.
authors.forename: Gianluca
authors.initials: G
authors.lastname: Campo
authors.affiliation: Cardiovascular Institute, Azienda Ospedaliero-Universitaria S.Anna, Cona (FE), Italy.
authors.forename: Rita
authors.initials: R
authors.lastname: Pavasini
authors.affiliation: Cardiovascular Institute, Azienda Ospedaliero-Universitaria S.Anna, Cona (FE), Italy.
authors.forename: Simone
authors.initials: S
authors.lastname: Biscaglia
authors.affiliation: Research Centre on Asthma and COPD, Section of Internal and Cardio-Respiratory Medicine, University of Ferrara, Ferrara, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Contoli
authors.affiliation: Cardiovascular Institute, Azienda Ospedaliero-Universitaria S.Anna, Cona (FE), Italy LTTA Center, Ferrara, Italy ccncld@unife.it ceconi1@tin.it claudio.ceconi@unife.it.
authors.forename: Claudio
authors.initials: C
authors.lastname: Ceconi
mesh_terms: D002317:Cardiovascular Agents / Q000627:therapeutic use*; D002318:Cardiovascular Diseases / Q000150:complications / Q000188:drug therapy*; D006801:Humans; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications / Q000188:drug therapy*; D012042:Registries
chemical_list: D002317:Cardiovascular Agents
keywords: ACE inhibitors; acetylcholine antagonists; cardiovascular disease; chronic obstructive pulmonary disease; heart failure; ischaemic heart disease; statins; β-blockers