Chronic Obstructive Pulmonary Disease in Patients with Atherosclerosis

Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality worldwide and affects approximately 10% of the adults of 40 years and older. It is currently the fifth leading cause of death and expected to be the third by 2020. This is mainly driven by the continued use of tobacco, and the population aging. Worldwide, approximately 2.7 million deaths from COPD occurred in the year 2000. COPD is defined by the Global Initiative for Chronic Lung Disease (GOLD) as a preventable and treatable disease characterized by airflow limitation that is not fully reversible. The airflow limitation is usually progressive and associated with an abnormal inflammatory response of the lungs to noxious particles or gases. This results in a chronic persistent low-grade inflammation in the lungs, and the intensity of the inflammation correlates with the severity of the disease. Importantly, the inflammatory state is not only restricted to the lungs but also extends systemically. This systemic inflammation is associated with the development of atherosclerosis and cardiovascular morbidity and mortality even after taken into account smoking status. Cardiovascular disease is a leading cause of mortality in patients with COPD and accounts for 20-25% of all deaths in COPD. In addition, for every 10% decrease of forced expiratory volume in 1 second (FEV1), the risk of cardiovascular mortality increases with 14% and non-fatal acute coronary events with 20%. Pulmonary complications contribute equally to postoperative morbidity, mortality as cardiac complications and prolong hospital stay by an average of one to two weeks.

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