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A Journal on Diseases of the Respiratory System
Official Journal of the Italian Society of Thoracic Endoscopy
Indexed/Abstracted in: EMBASE, Scopus, Emerging Sources Citation Index
Minerva Pneumologica 2014 December;53(4):175-9
Chronic obstructive pulmonary disease, coronary heart disese and sleep apnea syndrome: impact and interaction
Zamarrón C. 1, Del Campo Matías F. 2, Zamarrón De Lucas E. 3
1 Division of Respiratory Medicine, Hospital Clínico Universitario, Santiago de Compostela, Spain;
2 Division of Respiratory Medicine, Hospital Universitario Rio Hortega, Santiago de Compostela, Spain;
3 Division of Respiratory Medicine, Hospital Universitario La Paz, Madrid, Spain
Chronic obstructive pulmonary disease (COPD), coronary heart disease (CHD) and obstructive sleep apnea syndrome (OSAS) are highly prevalent in Western societies.
Epidemiologic and mechanistic studies indicate that COPD is associated with a high frequency of CHD. There is growing recognition that the chronic systemic inflammatory state associated with COPD is not confined to the lungs, but also involves the systemic circulation and can impact other organs. Although COPD and CHD have common causal factors such as primarily smoking and a sedentary lifestyle, and the increased CHD in patients with COPD is independent of these factors. The exact mechanism linking COPD to CHD although it is not well known, systemic inflammation, oxidative stress and hypoxemia are the major suspected factors. However, sleep disordered breathing frequently remains unrecognized and untreated among patients with COPD. Low-grade systemic inflammation occurs in patients with clinically stable COPD and many other chronic conditions, including CHD and sleep disordered breathing. The coexistence of these disorders may bring about the interaction of their underlying mechanisms and increase cardiovascular risk. Statins and inhaled corticosteroids have been investigated as potential therapeutic interventions in COPD that may lower this cardiovascular risk. In this review, we provide an overview of the epidemiologic and mechanistic data linking COPD and OSAS, as well as discuss their interrelationships with CHD.