The multiple components of COPD

Recent research suggests that inflammation is not confined to the lungs in COPD: inflammatory cells and mediators generated in the lungs enter the bloodstream and may have systemic effects on other susceptible areas of the body. This may account for the observation that patients with COPD also present with systemic symptoms and comorbid conditions, including muscle weakness, weight loss, cardiovascular disease, osteoporosis, hypertension, depression, cognitive decline, sleep disorders, sexual dysfunction, and possibly diabetes . Considering the systemic nature of the inflammatory response to irritants, particularly cigarette smoke, there is increasing evidence that lung abnormalities may be responsible not only for respiratory symptoms, e.g., dyspnea, but also for the chronic comorbidities that develop along with COPD, particularly chronic heart failure (CHF), coronary and peripheral vascular diseases, and the metabolic syndrome. Comorbidities are highly likely to affect health outcomes in COPD, and COPD patients are more likely to die of cardiovascular complications or cancer than of respiratory failure.