Identification and management of cardiopulmonary risk in patients with chronic obstructive pulmonary disease: a multidisciplinary consensus and modified Delphi study - Report - MDSpire

Identification and management of cardiopulmonary risk in patients with chronic obstructive pulmonary disease: a multidisciplinary consensus and modified Delphi study

  • By

  • Chris P Gale

  • John R Hurst

  • Nathaniel M Hawkins

  • Jean Bourbeau

  • MeiLan K Han

  • Carolyn S P Lam

  • Darcy D Marciniuk

  • David Price

  • Daiana Stolz

  • Ty Gluckman

  • Shelley Zieroth

  • Ramesh Nadarajah

  • Robert P Young

  • Dave Singh

  • Fernando J Martinez

  • David D Berg

  • Mohit Bhutani

  • the Global Working Group on Cardiopulmonary Risk

  • Amr Abdin

  • Dzifa Ahadzi

  • Albert B Albay

  • Bernardino Alcázar Navarrete

  • Luís Alves

  • Sameera Ansari

  • Antonio Anzueto

  • Felix Barasa

  • David D Berg

  • Andy Bevan

  • Mohit Bhutani

  • Giuseppe Biondi-Zoccai

  • Jean Bourbeau

  • Raffaele Bugiardini

  • Daniela Calderaro

  • Arturo Cortes-Telles

  • Michael G Crooks

  • Diego F Echazarreta

  • Nabil Farag

  • Fredrico L A Fernandes

  • Frits M E Franssen

  • Suzanne Fredericks

  • Chris P Gale

  • Olga M García Morales

  • Maria C Gaviria

  • Baris Gencer

  • Gonzalo Ernesto Gianella Malca

  • Kari Hanne Gjeilo

  • Ty Gluckman

  • Martha Gulati

  • MeiLan K Han

  • Nathaniel M Hawkins

  • Jeroen M Hendriks

  • John R Hurst

  • Anh-Thu Huynh Dang

  • Majdy M Idrees

  • Tobin Joseph

  • Nadim Kanj

  • Ee Ming Khoo

  • Bruce Kirenga

  • Leonie Klompstra

  • Martha Kyriakou

  • Carolyn S P Lam

  • Bouchra Lamia

  • Le Thi Tuyet Lan

  • Dominik Linz

  • Angela H E M Maas

  • Darcy D Marciniuk

  • Fernando J Martinez

  • Angela Massouh

  • Walter Mattarucco

  • Renata G Mendes

  • Anant Mohan

  • Trine Moholdt

  • Majid Mokhtari

  • Felicia Montero-Arias

  • Claudia Münks-Lederer

  • Shigeo Muro

  • Ramesh Nadarajah

  • Kazuhiro Nakao

  • Yoko M Nakao

  • Thu Nguyen Ngoc Phuong

  • Johanna O’Callaghan

  • Demosthenes Panagiotakos

  • Alberto Papi

  • Gerardo Payro

  • Massimo Piepoli

  • Marija Polovina

  • Bogdan A Popescu

  • David Price

  • Hany I Ragy

  • Keerthenan Raveendra

  • Christopher M Reid

  • Catherine Reynolds

  • Antonio Luiz P Ribeiro

  • Richard E K Russell

  • Lavanya Saiva

  • Juliana Salas Segura

  • Julie Sanders

  • Raewyn J Scott

  • Terence Seemungal

  • Dinesh Shrikrishna

  • Sami O Simons

  • Dave Singh

  • Yuanlin Song

  • Daiana Stolz

  • Abirami Subramaniam

  • Yongchang Sun

  • Raj Thakkar

  • Frederik Trinkmann

  • Izabella Uchmanowicz

  • Viola Vaccarino

  • Lowie E G W Vanfleteren

  • Rajesh Vedanthan

  • Tonya Winders

  • Jianhua Wu

  • Robert P Young

  • Jinping Zheng

  • Min Zhou

  • Shelley Zieroth

  • March 3, 2025

  • 0 min

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Clinical Report: Cardiopulmonary Risk Management in COPD Patients

Overview

Cardiovascular disease is a prevalent and underdiagnosed comorbidity in patients with chronic obstructive pulmonary disease (COPD), contributing to increased morbidity and mortality. A Global Working Group developed consensus recommendations emphasizing the importance of assessing and managing cardiopulmonary risk through multidisciplinary collaboration and guideline-based care.

Background

COPD is a chronic respiratory condition frequently complicated by cardiovascular comorbidities such as ischemic heart disease, heart failure, and arrhythmias. Shared risk factors like smoking and systemic inflammation contribute to this overlap, resulting in a two- to four-fold increased cardiovascular risk in COPD patients compared to controls. Despite this, cardiovascular disease remains under-recognized and undertreated in COPD populations, partly due to overlapping symptoms such as breathlessness. Addressing this gap is critical to improving patient outcomes.

Data Highlights

Key epidemiological data highlight that approximately 20% of COPD patients die from cardiovascular disease, with cardiovascular risk being highest in moderate COPD severity. The Global Working Group utilized a modified Delphi method to reach consensus on statements regarding cardiopulmonary risk identification and management in COPD, underscoring the need for spirometry in patients with cardiovascular risk factors and respiratory symptoms.

Key Findings

  • Cardiovascular disease is common and significantly increases mortality risk in COPD patients.
  • Shared risk factors and overlapping symptoms complicate diagnosis and management of cardiopulmonary risk.
  • Patients with cardiovascular risk factors and respiratory symptoms should undergo spirometry to confirm COPD diagnosis.
  • Management of cardiovascular comorbidities in COPD should follow established clinical guidelines.
  • Reducing COPD exacerbation risk is essential to lowering overall cardiopulmonary risk.
  • Enhanced multidisciplinary collaboration among pulmonologists, cardiologists, and primary care providers is recommended.

Clinical Implications

Clinicians should maintain a high index of suspicion for cardiovascular disease in patients with COPD, especially those presenting with respiratory symptoms and cardiovascular risk factors. Spirometry is a critical diagnostic tool to confirm COPD in such patients. Integrated care models involving cardiology, pulmonology, and primary care can optimize management, reduce exacerbations, and improve cardiopulmonary outcomes.

Conclusion

Effective identification and management of cardiopulmonary risk in COPD patients require multidisciplinary collaboration and adherence to clinical guidelines. Addressing this unmet need has the potential to significantly improve morbidity and mortality in this high-risk population.

References

  1. Global Working Group on COPD and Cardiovascular Disease 2024 -- Assessment and Management of Cardiopulmonary Risks in Individuals with COPD

Original Source(s)

Identification and management of cardiopulmonary risk in patients with chronic obstructive pulmonary disease: a multidisciplinary consensus and modified Delphi study

  • by Chris P Gale, John R Hurst, Nathaniel M Hawkins, Jean Bourbeau, MeiLan K Han, Carolyn S P Lam, Darcy D Marciniuk, David Price, Daiana Stolz, Ty Gluckman, Shelley Zieroth, Ramesh Nadarajah, Robert P Young, Dave Singh, Fernando J Martinez, David D Berg, Mohit Bhutani, the Global Working Group on Cardiopulmonary Risk, Amr Abdin, Dzifa Ahadzi, Albert B Albay, Bernardino Alcázar Navarrete, Luís Alves, Sameera Ansari, Antonio Anzueto, Felix Barasa, David D Berg, Andy Bevan, Mohit Bhutani, Giuseppe Biondi-Zoccai, Jean Bourbeau, Raffaele Bugiardini, Daniela Calderaro, Arturo Cortes-Telles, Michael G Crooks, Diego F Echazarreta, Nabil Farag, Fredrico L A Fernandes, Frits M E Franssen, Suzanne Fredericks, Chris P Gale, Olga M García Morales, Maria C Gaviria, Baris Gencer, Gonzalo Ernesto Gianella Malca, Kari Hanne Gjeilo, Ty Gluckman, Martha Gulati, MeiLan K Han, Nathaniel M Hawkins, Jeroen M Hendriks, John R Hurst, Anh-Thu Huynh Dang, Majdy M Idrees, Tobin Joseph, Nadim Kanj, Ee Ming Khoo, Bruce Kirenga, Leonie Klompstra, Martha Kyriakou, Carolyn S P Lam, Bouchra Lamia, Le Thi Tuyet Lan, Dominik Linz, Angela H E M Maas, Darcy D Marciniuk, Fernando J Martinez, Angela Massouh, Walter Mattarucco, Renata G Mendes, Anant Mohan, Trine Moholdt, Majid Mokhtari, Felicia Montero-Arias, Claudia Münks-Lederer, Shigeo Muro, Ramesh Nadarajah, Kazuhiro Nakao, Yoko M Nakao, Thu Nguyen Ngoc Phuong, Johanna O’Callaghan, Demosthenes Panagiotakos, Alberto Papi, Gerardo Payro, Massimo Piepoli, Marija Polovina, Bogdan A Popescu, David Price, Hany I Ragy, Keerthenan Raveendra, Christopher M Reid, Catherine Reynolds, Antonio Luiz P Ribeiro, Richard E K Russell, Lavanya Saiva, Juliana Salas Segura, Julie Sanders, Raewyn J Scott, Terence Seemungal, Dinesh Shrikrishna, Sami O Simons, Dave Singh, Yuanlin Song, Daiana Stolz, Abirami Subramaniam, Yongchang Sun, Raj Thakkar, Frederik Trinkmann, Izabella Uchmanowicz, Viola Vaccarino, Lowie E G W Vanfleteren, Rajesh Vedanthan, Tonya Winders, Jianhua Wu, Robert P Young, Jinping Zheng, Min Zhou, Shelley Zieroth

  • March 3, 2025

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