Comorbidities of chronic obstructive pulmonary disease

PURPOSE OF REVIEW: Defining the nature of the association between chronicobstructive pulmonary disease (COPD) and other chronic conditions is of primaryimportance to improve the health status of COPD patients through the optimal careof comorbidities. We aimed at providing a reasoned guide to understand, recognizeand treat comorbidity of COPD with the perspective of shifting from comorbidityto multimorbidity.RECENT FINDINGS: Select comorbidities, such as atherosclerotic disease,depression, chronic kidney disease, cognitive impairment, obstructive sleep apneasyndrome, lung cancer, osteoporosis, diabetes, heart failure, sarcopenia, aortic aneurysm, arrhythmias and pulmonary embolism are highly prevalent among olderCOPD patients. Several concerns may affect the management of older COPD patients with comorbidity (e.g. the use of β-blockers in patients with COPD andcardiovascular diseases or concerns about the cardiovascular safety of inhaledCOPD drugs).SUMMARY: Evidence suggests that systemic inflammation may be the link betweenCOPD and comorbidities, but this issue is still debated. Whatever the mechanismunderlying comorbidities in COPD may be, it has an important clinical, prognosticand therapeutic impact. Nevertheless, clinical practice guidelines do not takeinto account comorbidities in their recommendations. Additionally, clinicaltrials investigating COPD treatment in the context of multimorbidity andconsidering geriatric outcomes are also distinctly lacking.