Undertreating cardiovascular disease in people with chronic obstructive pulmonary disease (COPD)

Chronic obstructive pulmonary disease (COPD) is the third-leading cause of death globally following ischaemic heart disease and stroke.1 Cardiovascular disease (CVD) is one of the most common comorbidities experienced by people with COPD and is a leading cause of death. People with COPD account for about 40% of all cardiovascular hospitalisations.2 3 This is believed to be because of the direct effects of COPD on CVD, for example, by causing generalised inflammation that affects the heart, as well as shared common risk factors, such as smoking. Thus, prevention and management of CVD should be a high priority in the COPD population.

Reducing CVD risk can be done by managing modifiable risk factors such as smoking, hypertension and dyslipidaemia. The foundation for the primary prevention of CVD is CVD risk stratification, with guidelines recommending treatment with statins and antihypertensives in people who surpass a threshold risk, thereby gaining more benefits from those treatments than harms.4 Risk is calculated based on general population estimates but is revised upwards where certain risk-enhancing clinical factors are present, resulting in more people with those factors being treated. These risk-enhancing clinical factors include diseases …

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