Newcastle University Medical School, UK.
Cardiol Rev. 2013 Jul-Aug;21(4):196-202. doi: 10.1097/CRD.0b013e318279e907.
Cardiovascular diseases, especially coronary artery disease (CAD), are the leading causes of death in patients with chronic obstructive pulmonary disease (COPD). There is a high prevalence of common risk factors in the COPD/CAD patient population including smoking, sedentary lifestyle and low socio-economic status. However, various studies have shown that airflow limitation is an independent risk factor for cardiovascular diseases. Chronic low-grade systemic inflammation, oxidative stress and increased platelet activation have been widely reported to be pathophysiological links between COPD and atherosclerosis. Statins and inhaled corticosteroids have been investigated as potential therapeutic interventions in COPD that may lower cardiovascular risk. The goals of this review are to examine the evidence for increased cardiovascular risk in COPD patients, the possible mechanisms linking these two chronic conditions, to discuss possible predictors or markers of poor outcomes among patients diagnosed with both COPD and CAD, and the therapeutic options aimed at reducing cardiovascular risks associated with COPD.
心血管疾病，尤其是冠心病（CAD），是慢性阻塞性肺疾病（COPD）患者死亡的主要原因。在 COPD/CAD 患者人群中，存在许多常见的共同危险因素，包括吸烟、久坐的生活方式和低社会经济地位。然而，多项研究表明，气流受限是心血管疾病的独立危险因素。慢性低度全身炎症、氧化应激和血小板活化增加已被广泛报道为 COPD 和动脉粥样硬化之间的病理生理联系。他汀类药物和吸入性皮质类固醇已被研究作为 COPD 的潜在治疗干预措施，可能降低心血管风险。本综述的目的是检查 COPD 患者心血管风险增加的证据，探讨将这两种慢性疾病联系起来的可能机制，讨论同时诊断为 COPD 和 CAD 的患者不良结局的可能预测因子或标志物，以及旨在降低 COPD 相关心血管风险的治疗选择。
