[Update COPD and cardiovascular events].

Abstract

Chronic Obstructive Pulmonary Disease (COPD) is closely linked to cardiovascular disease (CVD), with up to 70% of COPD patients experiencing cardiovascular comorbidities. The coexistence of COPD and CVD significantly increases hospitalization rates, symptom burden, and mortality, particularly during acute exacerbations of COPD (AECOPD), which impose an increased risk of cardiovascular events - both during and shortly after these episodes. Mechanistic links between COPD and CVD include systemic inflammation, oxidative stress, endothelial dysfunction, and hypoxemia, all of which contribute to the progression of both conditions.Current management guidelines stress the importance of early screening and risk factor control for cardiovascular comorbidities in COPD patients. Different COPD therapies can affect cardiovascular outcomes in distinct ways. Recent research suggests that inhaled corticosteroids (ICS), either alone or as part of triple therapy (long-acting muscarinic antagonist [LAMA], long-acting beta-agonist [LABA], and ICS), may help reduce mortality and morbidity, particularly for those at higher risk. Furthermore, beta-blockers and statins have shown potential benefits for COPD patients with CVD, although their exact role is not entirely clear. Newer antidiabetic agents, such as SGLT-2 inhibitors, have also demonstrated promise in reducing exacerbation rates.This review emphasizes the need for an integrated care approach, highlighting the importance of personalized, guideline-driven therapies to enhance quality of life and clinical outcomes for COPD patients with cardiovascular comorbidities.