Unit of Respiratory Medicine, Department of Experimental Medicine, University of Rome 'Tor Vergata', Rome, Italy.
Institute of Pharmaceutical Science, King's College London, London, UK.
Drugs. 2024 Oct;84(10):1251-1273. doi: 10.1007/s40265-024-02086-5. Epub 2024 Sep 26.
Asthma and cardiovascular disease (CVD) often co-exist. When a patient has both conditions, management requires an approach that addresses the unique challenges of each condition separately, while also considering their potential interactions. However, specific guidance on the management of asthma in patients with CVD and on the management of CVD in patients with asthma is still lacking. Nevertheless, health care providers need to adopt a comprehensive approach that includes both respiratory and CVD health. The management of CVD in patients with asthma requires a delicate balance between controlling respiratory symptoms and minimising potential cardiovascular (CV) risks. In the absence of specific guidelines for the management of patients with both conditions, the most prudent approach would be to follow established guidelines for each condition independently. Careful selection of asthma medications is essential to avoid exacerbation of CV symptoms. In addition, optimal management of CV risk factors is essential. However, close monitoring of these patients is important as there is evidence that some asthma medications may have adverse effects on CVD and, conversely, that some CVD medications may worsen asthma symptoms. On the other hand, there is also increasing evidence of the potential beneficial effects of asthma medications on CVD and, conversely, that some CVD medications may reduce the severity of asthma symptoms. We aim to elucidate the potential risks and benefits associated with the use of asthma medications in patients with CVD, and the potential pulmonary risks and benefits for patients with asthma who are prescribed CVD medications.
哮喘和心血管疾病(CVD)常常同时存在。当患者同时患有这两种疾病时,管理需要采用一种分别针对每种疾病独特挑战的方法,同时考虑它们可能的相互作用。然而,关于心血管疾病患者中哮喘的管理以及哮喘患者中 CVD 的管理的具体指导仍然缺乏。尽管如此,医疗保健提供者需要采取一种综合的方法,包括呼吸和心血管健康。在哮喘患者中管理 CVD 需要在控制呼吸系统症状和最小化潜在心血管(CV)风险之间取得微妙的平衡。在缺乏针对同时患有这两种疾病的患者的管理指南的情况下,最谨慎的方法是独立遵循每种疾病的既定指南。仔细选择哮喘药物对于避免 CV 症状恶化至关重要。此外,还需要优化管理 CV 危险因素。然而,密切监测这些患者非常重要,因为有证据表明一些哮喘药物可能对 CVD 有不良影响,反之亦然,一些 CVD 药物可能会加重哮喘症状。另一方面,也有越来越多的证据表明哮喘药物对 CVD 可能有潜在的有益影响,反之亦然,一些 CVD 药物可能会减轻哮喘症状的严重程度。我们旨在阐明在 CVD 患者中使用哮喘药物相关的潜在风险和益处,以及在被处方 CVD 药物的哮喘患者中可能的肺部风险和益处。
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