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Cardiovascular Injury and Repair in Chronic Obstructive Pulmonary Disease

¹ ELEGI Colt Laboratories, MRC Centre for Inflammation Research, University of Edinburgh, Edinburgh, United Kingdom

Correspondence and requests for reprints should be addressed to Willam MacNee, M.D., ELEGI Colt Research Labs, The Queen's Medical Research Institute, The University of Edinburgh, Edinburgh, EH16 4TJ, Scotland, UK. E-mail: w.macnee{at}ed.ac.uk

ABSTRACT

Cardiovascular disease represents a considerable burden in terms of both morbidity and mortality in patients with chronic obstructive pulmonary disease (COPD). For 20 years, forced expiratory volume in 1 second (FEV₁) has been an established predictor of cardiovascular mortality among smokers, never-smokers, and patients with COPD. We review evidence for increased cardiovascular risk in COPD. In addition, we assess the emerging evidence which suggests that hypoxia, systemic inflammation, and oxidative stress in patients with COPD may cause cardiovascular disease. We also discuss alternative hypotheses that the endothelium and connective tissues in the arteries and lungs of patients with COPD and cardiovascular disease have a shared susceptibility to these factors.

Key Words: COPD • cardiovascular disease • systemic inflammation • endothelial dysfunction