ĐỒNG THUẬN ĐA CHUYÊN KHOA TRONG QUẢN LÝ NGƯỜI BỆNH BỆNH PHỔI TẮC NGHẼN MẠN TÍNH ĐỒNG MẮC BỆNH TIM MẠCH

Abstract

Background: Chronic obstructive pulmonary disease (COPD) is a common chronic respiratory disease frequently associated with multiple extrapulmonary comorbidities, particularly cardiovascular diseases (CVDs). The coexistence of COPD and CVD significantly increases symptom burden, hospitalization risk, healthcare utilization, and mortality. However, cardiovascular comorbidities are frequently underdiagnosed due to overlapping clinical manifestations. Therefore, the Vietnam Respiratory Society, in collaboration with the Vietnam National Heart Association, developed the multidisciplinary consensus document entitled “Multidisciplinary Consensus on the Management of Patients with Chronic Obstructive Pulmonary Disease and Concomitant Cardiovascular Disease”, based on scientific evidence from clinical practice guidelines, studies as well as national and international.

The consensus document consists of five chapters and four appendices and 65 references and was released in March 2026. The full text is available on the official websites of the Vietnam Respiratory Society (https://hoihohapvietnam.org) and the Vietnam National Heart Association (https://vnha.org.vn). Given the scope of the present article, we provide only a concise summary of the consensus document, with each section corresponding to the respective chapter of the original publication.

Content: COPD and cardiovascular diseases share several pathophysiological mechanisms, including smoking exposure, aging, systemic inflammation, oxidative stress, endothelial dysfunction, hypoxemia, autonomic imbalance, and pulmonary hyperinflation. Acute exacerbations of COPD are associated with a marked increase in cardiovascular events, including myocardial infarction, heart failure, arrhythmias, and cardiovascular death. Diagnosis requires systematic cardiovascular assessment in COPD patients and screening for COPD among patients with cardiovascular diseases. Optimal management requires close collaboration between respiratory and cardiovascular specialists. Treatment strategies include appropriate use of long-acting bronchodilators, triple inhaled therapy (ICS/LABA/LAMA) in patients with frequent exacerbations, continuation of evidence-based cardiovascular therapies including cardioselective beta-blockers, renin–angiotensin system inhibitors, SGLT2 inhibitors, and comprehensive non-pharmacological interventions such as smoking cessation, pulmonary rehabilitation, and vaccination.

Conclusion: COPD with cardiovascular comorbidities represents a complex clinical condition requiring an integrated multidisciplinary approach. Early recognition and coordinated management may improve disease control, reduce cardiovascular events, and enhance long-term outcomes.