Pulmonary Rehab: Daily Fitness & Exercise
Keeping Your Heart Healthy With COPD
When you have COPD, your lungs aren't the only concern. Find out why COPD and heart disease are closely connected, and how you can improve both your lung and heart health.
By Beth W. Orenstein
Medically Reviewed by Lindsey Marcellin, MD, MPH
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Having chronic obstructive pulmonary disease (COPD) can make it hard to breathe when you exert yourself, even during normal activities such as walking, cooking, or getting dressed. Likewise, having heart disease can leave you short of breath. The symptoms of the two are so much alike that, very often, doctors have to investigate whether your shortness of breath is due to COPD or heart disease — or both.
COPD and heart disease are closely related, says Larry Santora, MD, FACC, of the Orange County Heart Institute, and director of the Heart and Vascular Wellness Center at Saint Joseph Hospital in Orange, Calif.
The Link Between Your Heart and Your Lungs
COPD weakens your lungs and can cause a drop in oxygen levels in the body, a condition known as hypoxia. When your lungs are weak, it makes it harder for your heart muscle to get enough oxygen. When your heart doesn't get enough oxygen, you can suffer a heart attack.
When your lungs are weak, it also can cause a serious condition known as pulmonary hypertension. As Dr. Santora explains it, the major blood vessels that carry blood from the right side of the heart to the lungs, where it is oxygenated, are known as the pulmonary arteries. When you have COPD, these arteries can become stiff or narrow, causing the pressure in them to rise, which in turn puts stress on the right chamber of your heart. The stress on the right ventricle causes it to weaken and lose its ability to pump enough blood to the lungs. Pulmonary hypertension can lead to right heart failure.
Some people with severe COPD can have mild heart failure. Other people can have severe heart failure and mild COPD. In most cases, Santora says, whichever condition is more severe is the one that is probably causing your symptoms.
Improving Heart Health and COPD Symptoms
When you have COPD, heart health is critical. Here's what you should do to improve your lung and heart function:
Quit smoking."Stopping smoking is the most important thing you can do for both diseases," says R. Graham Barr, MD, DrPH, a pulmonary specialist and assistant professor of medicine and epidemiology in the department of medicine at Columbia University in New York City. The vast majority of of COPD cases in the United States are caused by smoking. Smoking also causes coronary artery disease, which leads to heart attack. Talk to your doctor about finding a method of quitting that will work for you.
See your doctor about your COPD symptoms.Shortness of breath when you exert yourself could be caused by COPD or heart disease. Your doctor can perform several tests, including an echocardiogram, to evaluate the chambers of your heart and pumping strength, Santora explains. Your doctor also will test for a hormone called brain natriuretic peptide (BNP), which is often elevated in people with heart failure. Knowing the cause of your symptoms will help your doctor determine the most appropriate course of treatment for you.
Know your cholesterol and your blood pressure.These are key numbers for heart health. If these numbers are high, you can talk with your doctor about preventive treatments and what you can do to lower your numbers.
Manage your weight.When you have COPD, "it's crucial to keep your weight down," Santora says. "If you have a big belly, it can push up on your lungs, and the extra fat makes it harder for your heart to function." It's also important that you eat a heart-healthy diet that's high in fruits, vegetables, and whole grains, and low in fats and sugars. Choose lean meats and low-fat dairy products, and prepare your foods by grilling or broiling rather than frying or dousing with rich sauces.
Exercise regularly.You need both aerobic exercise, such as walking or bicycling, and exercises that strengthen your upper body, Santora says. "Exercise is the best medicine for lung disease," he says. "If you exercise, you keep your muscles in shape, and the heart is a muscle." Talk to your doctor before starting an exercise program and together work out a routine that is safe for you.
Talk to your doctor about your medications.Doctors have long believed that some heart medicines, particularly beta blockers that slow the heart rate, aren't safe for people who also have COPD. But a recent Dutch study by physicians at the University Medical Center Utrecht has indicated that fears about giving beta blockers to COPD patients may be unfounded. The researchers found that patients with COPD who were given beta blockers fared better than those who were not. Discuss your medications with your doctor to help determine what's best for you.
Both COPD and heart disease can be serious and life-threatening, but if you make these important lifestyle changes, you will be able to stay more active and slow the progression of both conditions.
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