The most common symptoms involve shortness of breath, especially on exertion, production of sputum and cough. This disease affects 6.7 percent of the U.S. population and is the third leading cause of mortality.
Since it is a devastating and debilitating chronic disease with no cure, anything that can prevent COPD exacerbations is critically important.
What are the traditional ways to reduce the risk of and treat COPD exacerbations? The most important step is to stop smoking, since 80 percent of COPD is related to smoking.
Supplemental oxygen therapy and medications, such as corticosteroids, bronchodilators, and antibiotics help to alleviate symptoms.
One of the underlying components of COPD may be chronic inflammation. Therefore, reducing inflammation may help. There are several inflammatory biomarkers that could potentially help predict exacerbations and mortality associated with this disease.
How do we reduce inflammation? Some drugs, such as statins, work partially by reducing inflammation. They may have a role in COPD. Lifestyle changes that include a high-nutrient, anti-inflammatory diet and exercise may also be beneficial.
In a population-based study with over 60,000 participants, results showed that as three biomarkers (C-reactive protein, leukocyte count and fibrinogen) were elevated, COPD exacerbation risk increased in a linear manner.
In other words, the risk of frequent exacerbation increased 20, 70 and 270 percent within the first year as the number of elevated biomarkers increased from one to three, compared to patients who did not have biomarker elevations.
Patients with stable and mild COPD who had all three biomarkers elevated for longer periods had a 150 percent increased risk of frequent exacerbations.
Biomarker trials are exciting for their potential to shape treatments, creating more individualized therapies. Many of these biomarkers are identifiable with simple blood tests at major labs.
Statins have been maligned for their side effects, but their efficacy has been their strong suit. A retrospective study with over 14,000 participants showed that statins led to at least a 30 percent reduction in the risk of COPD exacerbations. As the dose increased, so did the benefit.
The greatest benefit was seen in those who historically had been on a medium to high dose or were on the drug currently. The researchers believe that the mechanism of action for statins in this setting has to do with their anti-inflammatory and immune-modulating effects.
Exercise is beneficial for almost every circumstance, and COPD is no exception. But did you know that a pedometer might improve results?
In a three-month study, those with mild COPD were much more successful at achieving exercise goals and reducing exacerbations and symptoms when they used pedometers. Pedometers gave patients objective feedback about their physical activity level, which helped motivate them to achieve the study goal of walking 9,000 steps daily.
When exercising, we are told to vary our routines. One study demonstrates that this may be especially important for COPD patients. Results show that altering the time spent working out, the number of sets, the number of repetitions and the intensity of the workout is better than traditional routines of endurance and resistance training in severe COPD patients.
Significantly, more severe COPD patients also achieved their exercise goals than with the traditional approach. They also had an improved quality of life response.
Chronic inflammation may play a central role in COPD exacerbation. Drugs that can control inflammation, such as statins, show promise. But don’t forget the importance of lifestyle changes, such as quitting smoking, eating an anti-inflammatory diet, and committing to a varied exercise regimen.
For further information, visit medicalcompassmd.com or consult your personal physician.