Does COPD and its Exacerbations Truly Impact Cardiovascular and Cerebrovascular Health? Is this Impact Modifiable?
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Abstract
In Argentina, tobacco consumption causes over 47,000 deaths annually, primarily due to cancer, cardiovascular diseases (CVD), chronic obstructive pulmonary disease (COPD), pneumonia, and stroke (CVA). Nearly 7,000 people die from COPD in Argentina each year. It affects 14.5% of Argentinians over 40, with a concerning rate of underdiagnosis. A narrative review of the main scientific databases was conducted between 1996 and 2025. This article aims to analyze why COPD and its exacerbations are risk factors for CVD and CVA, and the preventive strategies that have shown to reduce these risks.
Patients with COPD have a higher prevalence of CVD, and its severity correlates with an increased risk of cardiovascular and overall mortality. Acute respiratory infections, such as influenza, respiratory syncytial virus (RSV), SARS-CoV-2, and Streptococcus pneumoniae, associated with COPD exacerbations "per se", significantly increase the risk of cardiovascular and cerebrovascular events. COPD exacerbations drastically raise cardiovascular and cerebrovascular morbidity and mortality for up to a year after the event.
To prevent cardiovascular and cerebrovascular impact in patients with COPD, several interventions are crucial. Smoking cessation is the most cost-effective intervention, reducing mortality. Respiratory rehabilitation and regular physical activity (over 10,000 steps daily) improve health and decrease overall, cardiovascular, and respiratory mortality. Vaccination against influenza and pneumococcus significantly reduces the risk of major cardiovascular events and mortality. Finally, inhaled triple therapy in frequent COPD exacerbator patients with >300 eosinophils/µl has shown to reduce mortality and cardiovascular events.
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