Clinical Challenges in the Best Management of Heart Failure and Chronic Obstructive Pulmonary Disease (COPD)

Given the shared risk factors and pathophysiological pathways between heart failure and COPD, it is not surprising that these two conditions frequently coexist. The prognosis of a patient with COPD who is also diagnosed with HF is significantly worse, but vice versa is true for the patient who is already diagnosed with COPD. Even with the use of “gold-standard” diagnostic tests, distinguishing between the two is a huge clinical challenge. However, early detection and treatment of the underlying disease process have a significant impact on symptoms, quality of life, and, in the case of HFrEF, long-term results. Once HFrEF has been identified, it is crucial to start treatment as soon as possible with the best medical medication. Beta-blockers should be used with caution, although having COPD concurrently should not be a justification for doing so.
Beta-blockers should be used with caution, although the presence of COPD should not prevent patients from receiving treatment. If non-selective beta-blockers like carvedilol cause bronchoconstriction, switching to a cardio-selective beta-blocker like bisoprolol may be helpful. Remember that the majority of HFrEF therapies, such as loop diuretics, may also be beneficial for COPD in people with both diagnosis. Data on whether COPD medicines are hazardous to people with HF are mixed; in some circumstances, patients who have COPD and HF together should have their inhaled therapy reduced. Accurate diagnosis and proper long-term treatment balancing are challenging but crucial for improving management of both illnesses.
Source: Published 25 October 2022 Volume 2022:15 Pages 7961—7975