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1607616726Pulmonary.pdf Respiratory Medicine Series Editor: Sharon I.S. Rounds For further volumes: http://www.springer.com/series/7665 Linda Nici ● Richard ZuWallack Editors Chronic Obstructive Pulmonary Disease Co-Morbidities and Systemic Consequences Editors Linda Nici, MD Clinical Professor of Medicine The Warren Alpert Medical School of Brown University Chief, Pulmonary and Critical Care, Providence Veterans Affairs Medical Center Providence, RI, USA linda_nici@brown.edu Richard ZuWallack, MD Clinical Professor of Medicine University of Connecticut School of Medicine Associate Chief Pulmonary and Critical Care St. Francis Hospital and Medical Center Hartford, CT, USA rzuwalla@stfranciscare.org ISBN 978-1-60761-672-6 e-ISBN 978-1-60761-673-3 DOI 10.1007/978-1-60761-673-3 Springer New York Dordrecht Heidelberg London Library of Congress Control Number: 2011935361 © Springer Science+Business Media, LLC 2012 All rights reserved. This work may not be translated or copied in whole or in part without the written permission of the publisher (Humana Press, c/o Springer Science+Business Media, LLC, 233 Spring Street, New York, NY 10013, USA), except for brief excerpts in connection with reviews or scholarly analysis. Use in connection with any form of information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed is forbidden. The use in this publication of trade names, trademarks, service marks, and similar terms, even if they are not identified as such, is not to be taken as an expression of opinion as to whether or not they are subject to proprietary rights. While the advice and information in this book are believed to be true and accurate at the date of going to press, neither the authors nor the editors nor the publisher can accept any legal responsibility for any errors or omissions that may be made. The publisher makes no warranty, express or implied, with respect to the material contained herein. Printed on acid-free paper Humana Press is part of Springer Science+Business Media (www.springer.com) v Preface Chronic Obstructive Pulmonary Disease (COPD) is a preventable and treatable disease with commonly associated co-morbidities and significant systemic consequences. It is the fourth leading cause of death worldwide and the only one of the top ten leading causes of death that has shown a steady increase in morbidity and mortality. A major challenge in controlling and treating COPD is understanding its complexity. While COPD can be simplistically defined as a disease characterized by airflow limitation, we now understand it as a multicomponent disease with many clinical phenotypes. Evidence is rapidly emerging that COPD has a potent inflammatory basis which likely plays a role in the systemic consequences of the disease, including peripheral muscle, cardiac, nutritional, and psycho-social dysfunction. These systemic consequences are responsible for a large portion of the morbidity from this disease. Furthermore, patients with COPD are more likely to have significant co-morbid conditions, such as cardiovascular disease, that contribute to morbidity and mortality and present challenges when designing treatment guidelines. Chronic Obstructive Pulmonary Disease: Co-Morbidities and Systemic Consequences uses a wide angle lens to view COPD, bringing into focus the ever- important extrapulmonary aspects of this disease. The chapters included here were all prepared by internationally recognized thought leaders in the field. Our common purpose was to examine and understand the complex nature of COPD, recognize its common co-morbidities and systemic consequences, and offer suggestions for com- prehensive treatment strategies. The first section of the book provides an overview of the role of co-morbidities, the basis for systemic inflammation, and how these impact on the disablement pro- cess in COPD. The following two sections provide in-depth analysis of the most common co-morbidities and systemic consequences associated with COPD. The last section of this book addresses treatment of these medically complex patients by discussing the need for transcending disease-specific guidelines, providing novel pharmacologic treatment strategies, and giving comprehensive pulmonary rehabili- tation. The book concludes with a look to the future, emphasizing the importance of ...