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COPD Comorbid Conditions: Heart Disease, Osteoporosis, and More

Specific Comorbidity Risks

The link between COPD and heart disease has received the most attention. Compared to people without COPD, people with COPD are more likely to be put in the hospital with angina, heart attacks, fibrillation, heart failure and blood clots.3

In a large study of nurses, those with COPD were much more likely to develop diabetes. There was no link found between asthma and diabetes.4 Many with COPD have low Vitamin D levels. Osteoporosis is very common and the risk is increased in men as well as women. Men with COPD in their 60s have the same risk of getting osteoporosis as postmenopausal women.5 Depression and anxiety have been found to be more common in COPD than in other serious chronic illnesses. These other chronic illnesses include heart disease, kidney disease, AIDS and cancer.6 Gastroesophageal reflux disease (GERD) is very common in COPD. It is more common in more severe COPD. It often does not have typical heartburn symptoms. There is increasing evidence that GERD may lead to exacerbations.7  

People with COPD are at increased risk for getting lung cancer. This risk may be greater in women.8 Many of these conditions are caused by smoking. COPD patients are at an increased risk of getting these conditions compared to smokers who do not have COPD.

Comorbidities and the Increased Risk of Hospitalization/Death

COPD is a leading cause of hospital stays. This is especially true for older patients. Comorbid conditions are a common or contributing cause of many of these hospital stays. Cardiac events, pneumonias and blood clots are among the most common comorbid conditions that lead to COPD hospital stays. Whatever the reason for the hospital stay, the more comorbid conditions, the longer the hospital stay will be.9

COPD is the fourth leading cause of deaths in adults in the United States. However, there is increasing evidence that many if not most of these deaths are not due to the COPD. Instead, the deaths are caused by comorbid conditions, especially cardiac events and cancer.10

Why are Comorbidities so Common in COPD?

No one really knows the answer to that question.

Some of it may have to do with ageing. As we get older we are all more likely to develop medical problems. Folks with significant COPD tend to be a bit older. Cigarette smoking remains the most common risk factor for COPD in the United States. We know that cigarette smoking can contribute to many other medical problems. These include coronary heart disease, peripheral vascular disease, strokes, osteoporosis, cataracts, erectile dysfunction, peptic ulcer disease, poor wound healing and a long list of cancers. But nonsmokers with COPD have many comorbid conditions as well. So, the increase in comorbid conditions in COPD patients cannot be just about smoking. For smokers with COPD, the risks are increased compared to smokers without COPD.

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