Flare ups of COPD are called exacerbations and we have discussed them before. I have often said that these attacks are the equivalent of heart attacks for patients with heart disease and if we called them “lung attacks” they might get the attention from patients, as well as physicians, that they deserve.

The symptoms of a lung attack include increased cough with sputum production and often wheezing and more shortness of breath. Exacerbations serious enough to take someone to the hospital and be admitted confirm on the patient a long list of unpleasant statistics, including the fact that 50% of the patients will not be alive in 5 years. Added to the lung statistics associated with an exacerbation is new data on the risk of strokes in this population.

Recent studies have shown that patients with COPD have a 20% higher risk of stroke over the normal population and that this risk is highest in the period following an acute exacerbation. In a study of over 13,000 individuals, patients with COPD had a 6.7 times greater risk of stroke during the seven weeks fol- lowing a severe exacerbation. Smoking was the factor most associated with stroke and COPD.

Patients with hypertension and COPD were at particular risk for cerebral hemorrhage (hemorrhagic stroke). The best way to prevent COPD is to stop smok- ing. Once the disease has been triggered it can be helped but not stopped. Once you have had a stroke any permanent neurologic injury cannot be returned.