Not a day goes by without me telling a patient to wash their hands and do
whatever they can to prevent an infection that could lead to a flare-up of their
COPD, which we call an exacerbation. Aside from the problems inherent in
controlling the increased lung symptoms during one of these attacks, acute
exacerbations of COPD could also trigger a major cardiac event, such as a heart
attack or a stroke, particularly in older patients.
In a recent study of over 118,000 patients, it was found that the risk of a
major cardiac event (such as a heart attack) increased 270% in the 4 weeks after
the onset of an exacerbation. There was a 333% increase in the risk of
cardiovascular death and a 257% increase in the risk of having a heart attack.
There was a 178% increase in the risk of stroke during this same period. You may
think these numbers are a typo but they are real, and staggering. These risks were
not just confined to patients treated in the hospital, but also to those treated at
The cause for these dramatic risk figures may have something to do with
the marked increase in what are called systemic inflammatory markers. These are
proteins in our body, which increase in amount when exacerbations occur, and
may lead to an increase in blood clotting in blood vessels, especially those that
already have disease due to smoking.
If you have COPD, do your best to prevent exacerbations.