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Heart Failure and COPD: What’s the Connection?

Medically reviewed by Angelica Balingit, M.D.
Posted on August 30, 2023

Having a lung disease like chronic obstructive pulmonary disease (COPD) can complicate daily life. But recognizing COPD’s potential connections with other conditions, like heart failure, may help you prevent additional medical problems.

“I was 39 when I was told I had COPD, asthma, and ischemic heart disease,” said a MyCOPDTeam member. “I’m now 57 and at stage 4. It’s not easy coping with it, but I have to carry on. The nurses and my doctors are very good and help me through it.”

Heart disease, also called cardiovascular disease, has some shared risk factors with COPD. Fortunately, many of the lifestyle recommendations to help manage COPD can also help reduce your risk of heart disease. By learning about the connection between COPD, heart disease, and heart failure, you can take steps to improve your overall health and well-being.

What Is Heart Failure?

Heart failure is a serious medical condition when the heart doesn’t pump blood efficiently. In untreated heart failure, the body’s organs and tissues can’t get enough oxygen. Heart failure usually affects the left side but can also impact the right side of the heart. Congestive heart failure affects both sides. Like COPD, heart failure is classified into stages based on severity.

In the United States, there are about 6.2 million adults living with heart failure. Data from 2018 suggests that heart failure may have been a factor in 13.4 percent of total deaths in the U.S.

Heart failure is managed with lifestyle changes, medications, and sometimes surgery. Not smoking, avoiding too much salt and alcohol, and staying physically active can help protect your heart.

There are four different groups of heart failure medications, including beta-blockers, diuretics, and ACE inhibitors. People at risk of heart failure may also be prescribed statins to lower cholesterol. Devices like pacemakers or defibrillators can help treat heart failure in some cases. A cardiologist will perform tests to determine the underlying cause of heart failure before deciding on the best treatment options.

Connection to COPD

Heart failure and COPD have a few things in common. For instance, a history of smoking increases your risk of developing both conditions. Additionally, shortness of breath and fatigue are primary symptoms of both conditions.

Another connection between COPD and heart failure is that COPD increases the workload on the right side of the heart, which can lead to right-sided heart failure.

“I have heart failure now,” shared a MyCOPDTeam member. “I’m just starting to feel a little bit better. The swelling on my ankles and legs has gone down, but I’m still struggling to walk and using a wheelchair.”

Another member wrote, “I pray that my emphysema and congestive heart failure don’t get worse. Today my breathing is not so good. I’m having a hard time inhaling without coughing. I get dizzy and lightheaded. I’m using all of my meds and inhalers.”

Unfortunately, heart failure is much more common in people with COPD than in the general population. One study reported that the prevalence of heart failure in those with COPD is 18.8 percent — compared to 1.6 percent in those without COPD. If you have COPD, reducing your risk and following through with your doctor’s treatment recommendations can help you balance this potential complication.

Shared Risk Factors

COPD and heart failure share several overlapping causes. Some characteristics, like genetics, aren’t as well understood but still may contribute to both conditions.

Smoking and Environmental Pollutants

Exposure to smoke and pollution is one of the biggest risk factors for both COPD and heart failure. Over time, cigarette smoke damages the airways and lungs, leading to COPD. Smoking also causes inflammation and damage to blood vessels, increasing the risk of heart disease and heart failure. Similarly, other environmental pollutants, like air pollution, can negatively affect your overall health.

Chronic Inflammation

Both COPD and heart failure involve chronic inflammation. COPD causes ongoing inflammation in the lungs, while heart failure causes inflammation in the heart muscle. This persistent inflammatory state can aggravate the progression of both conditions. Scientists believe that chronic inflammation from COPD increases various signs of heart disease, like atherosclerosis (hardening of the arteries).

When systemic inflammation levels spike after a COPD exacerbation (increase in severity), the risk of a cardiovascular event goes up. Being mindful of your health after a COPD exacerbation (even once you start to feel better) is essential for preventing complications.

Aging

Age is a common risk factor for both COPD and heart failure. As people grow older, their risk of developing these conditions increases — particularly if they have a history of smoking or other relevant risk factors.

Sedentary Lifestyle

Heart failure or COPD may limit your ability to be physically active. However, a sedentary lifestyle with most of the day spent sitting or lying down, is a risk factor for both conditions.

Living With Both Conditions

It’s not unusual for people with comorbidities (multiple health conditions) to have worse health outcomes and higher rates of hospitalization. Heart disease is a leading cause of death for people with COPD.

Heart failure can significantly impact life with COPD. When the heart struggles to pump blood effectively, less oxygen is delivered to the lungs and body, thereby worsening the symptoms of COPD. Additionally, fluid buildup associated with heart failure can further compromise lung function and increase shortness of breath, making it harder to carry out daily activities.

Similarly, COPD can worsen heart failure symptoms. The impaired lung function in COPD can reduce oxygen levels in the blood. As a result, the heart has to work harder to pump oxygen to the rest of the body. This added strain on the heart can cause heart failure to progress faster.

While many of the recommended treatments for heart failure and COPD overlap, some may oppose each other. Discuss with your health care provider how treatment for one condition may affect another.

Take Charge of Your Health

If you have COPD, it’s best to focus on changes you can make to improve your quality of life. In addition to working with your doctor on your medical treatment plan, some health-related goals may include:

  • Not smoking — If you smoke, quitting is the single most important step you can take to slow the progression of both COPD and heart failure.
  • Improving your diet — Adopting a nutritious diet that’s low in sodium and focused on heart-healthy fats can benefit both conditions.
  • Exercising safely — Regular exercise, as advised by your health care provider, can strengthen your heart and pulmonary function.
  • Attending all of your doctor’s appointments — Stay connected with your health care providers — including your primary care, cardiology, and pulmonary specialists — and make sure they’re aware of what medications and supplements you’re taking.

While these goals should come as no surprise, they’re not always easy to achieve. For example, most people who smoke need support to quit, and succeeding may take several attempts. Don’t get discouraged. It’s important to never give up on your health. Seeking social support through your local community or online can help you find the motivation to keep trying.

Talk With Others Who Understand

On MyCOPDTeam, the social network for people with COPD and their loved ones, more than 119,000 members come together to ask questions, give advice, and share their stories with others who understand life with COPD.

Did you know about the increased risk of chronic heart failure after a diagnosis of COPD? How do you manage the higher risk of comorbidities? Share your experience in the comments below, or start a conversation by posting on your Activities page.

    Posted on August 30, 2023
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    Angelica Balingit, M.D. is a specialist in internal medicine, board certified since 1996. Learn more about her here.
    Anastasia Climan, RDN, CDN is a dietitian with over 10 years of experience in public health and medical writing. Learn more about her here.

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