Cemil GÜRGÜN, Alev GÜRGÜN

Kronik obstrüktif akciğer hastalığı ve kardiyovasküler sistem

Kronik obstrüktif akciğer hastalığı (KOAH), tüm dünyada her yıl yaklaşık 3 milyon kişinin ölümüne neden olan en önemli morbidite ve mortalite nedenlerinden birisidir. En iyi bakış açısıyla bile önümüzdeki 15 yıl içinde KOAH’a bağlı mortalite oranlarının yaklaşık %50 oranında artması beklenmektedir. KOAH’lı olgularda; kardiyovasküler hastalıklar, akciğer kanseri, osteoporoz ve kas güçsüzlüğü riski artmıştır. Sigara içimi, KOAH ve kardiyovasküler hastalıklar açısından iyi tanımlanmış bir risk faktörü olmasına karşın, diğer bazı nedenlerin de bu hastalıklara yol açtığı sanılmaktadır. Sistemik inflamasyon, her iki hastalıkta da tanımlanan en önemli etyolojik nedendir. Bu derlemede; KOAH ve kardiyovasküler hastalıklar, özellikle de ateroskleroz arasındaki yakın ilişki, ortak patogenetik mekanizmalar, kardiyovasküler komorbiditeler ve solunum fonksiyonlarıyla bağlantısı, her iki hastalığın tedavisinde kullanılan ilaçların rolü, kardiyovasküler komorbid durumların prognoz üzerindeki etkileri ve mortalitenin önceden belirlenmesi konuları tartışılmıştır. İnhale kortikosteroidlerin ve statinlerin antiinflamatuvar etkileri, kardiyovasküler patolojiler ve tüm nedenlere bağlı mortalite ile KOAH sağkalımı üzerindeki etkileri, yeni tedavi perspektifleri olarak irdelenmiştir.

Chronic obstructive pulmonary disease and cardiovascular system

Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality worldwide killing nearly 3 million people annually. Even the most optimistic estimates suggest that COPD mortality rates will increase by 50% over the next 15 years. Individuals with COPD are at increased risk of cardiovascular diseases (CVD), lung cancer, osteoporosis and muscle wasting. Smoking is a well-described risk factor for both COPD and CVD, but CVD in patients with COPD is likely to be due to other factors in addition to smoking. Systemic inflammation may be an important common etiological cause between COPD and CVD, being well described in both diseases. This paper reviews the close relationship between COPD and cardiovascular diseases, principally atherosclerosis. The common pathogenetic mechanisms, relation between cardiovascular comorbidities and pulmonary function parameters, the treatment of pulmonary and systemic inflammation, the role medications in the treatment of both disorders, the effect of cardiovascular comorbidities on the prognosis of COPD and prediction of mortality is discussed. The anti-inflammatory effects of inhaled corticosteroids and statins, their effects on cardiovascular endpoints, all-cause mortality, and survival of COPD patients are rewieved as a new perspective to the treatment.

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