In many of these articles I have referred to COPD exacerbations, or what we sometimes call “lung attacks”. These flare-ups of disease can be caused by infection, changes in air temperature and humidity, smoking, exposure to inhaled irritants, allergens, and a variety of other causes. Keeping patients free from exacerbations is one of the goals of therapy. Some of the causes are preventable, such as smoking, but some are difficult to control, like infections. Regardless of the cause, it is vital to prevent as many lung attacks as possible because each episode carries with it consequences, some of which are dire.
Recently, a group of investigators examined the risk of heart attacks and strokes associated with COPD exacerbations and the findings were sobering. It was noted that within 90 days following an exacerbation there was a 65% increased risk of a heart attack and a 57% increased risk of a stroke. Although these risks were spread out over 90 days, the peak period for a heart attack was 3 days after the onset of the COPD exacerbation. For stroke the peak onset was 4-7 days after the acute exacerbation. Nothing changed the risk for a heart attack, but taking aspirin seemed to lower the risk of stroke.
The patient and pulmonary physician need to work together to prevent lung attacks. Hand washing and avoiding situations that could provoke and exacerbate is the patient’s task. Physicians need to prescribe appropriate long- term and acute treatment when attacks occur.
