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Vol. 46. Issue S11.
Aspectos relevantes en EPOC
Pages 20-25 (December 2010)
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Vol. 46. Issue S11.
Aspectos relevantes en EPOC
Pages 20-25 (December 2010)
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Comorbilidades de la EPOC
Comorbidities in COPD
Visits
...
Javier de Miguel Díez
Corresponding author
jmiguel.hgugm@salud.madrid.org

Autor para correspondencia.
, Teresa Gómez García, Luis Puente Maestu
Servicio de Neumología, Hospital General Universitario Gregorio Marañón, Universidad Complutense, Madrid, España
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Resumen

Las comorbilidades asociadas a la enfermedad pulmonar obstructiva crónica (EPOC) son el conjunto de alteraciones y trastornos que pueden encontrarse asociados, por uno u otro motivo, a esta enfermedad. Pueden ser causales (otras enfermedades de las que también el tabaquismo es la causa, como la cardiopatía isquémica o el cáncer de pulmón), una complicación (una hipertensión pulmonar o una insuficiencia cardíaca), una coincidencia (un trastorno relacionado con la edad avanzada como la hipertensión arterial, la diabetes mellitus, la depresión o la artrosis) o una intercurrencia (un proceso agudo, generalmente limitado en el tiempo, como una infección respiratoria). De todas ellas, las que se asocian a la EPOC con una mayor frecuencia son la hipertensión arterial, la diabetes mellitus, las infecciones, el cáncer y las enfermedades cardiovasculares. Las comorbilidades en la EPOC no sólo contribuyen a aumentar la repercusión social y el coste anual de la enfermedad, sino que también constituyen un factor pronóstico de mortalidad en los pacientes en los que existen. De hecho, se ha demostrado que, además de la insuficiencia respiratoria, la cardiopatía isquémica y las neoplasias son causas frecuentes por las que fallecen los individuos que tienen una EPOC. En este capítulo se abordan las comorbilidades de la EPOC más relevantes por su frecuencia, por la repercusión que producen o por la mortalidad que originan. Aunque no se conoce con exactitud, el mecanismo común a todas ellas puede ser la inflamación sistémica y sus mediadores, que desempeñan un papel importante en su patogenia.

Palabras clave:
EPOC Enfermedad cardiovascular Infección respiratoria Cáncer de pulmón Disfunción muscular esquelética Diabetes mellitus Osteoporosis Anemia Trastornos psiquiátricos
Abstract

The comorbidities of chronic obstructive pulmonary disease (COPD) consist of all the alterations and disorders associated, for one reason or another, with this disease. These comorbidities may be causal (other diseases also caused by smoking, such as ischemic heart disease or lung cancer), a complication (pulmonary hypertension or heart failure), a concurrence (disorders related to advanced age such as hypertension, diabetes mellitus, depression or osteoarthritis) or an intercurrent process (an acute process, generally time-limited, such as a respiratory infection). Of all these comorbidities, those most frequently associated with COPD are hypertension, diabetes mellitus, infections, cancer and cardiovascular diseases. Comorbidities in COPD not only increase the social repercussions and annual cost of the disease but are also a prognostic factor for mortality in affected individuals. Indeed, in addition to respiratory failure, frequent causes of death in patients with COPD are ischemic heart disease and malignancies. The present article discusses the comorbidities of COPD with the greatest impact due to their frequency or influence on mortality. Although not precisely known, the common mechanism of all these comorbidities could be systemic inflammation and its mediators, which play an important role in the pathogenesis of COPD.

Keywords:
COPD Cardiovascular disease Respiratory infection Lung cancer Skeletal muscle dysfunction Diabetes mellitus Osteoporosis Anemia Psychiatric disorders
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