Dyspnea is a classical sign of chronic obstructive pulmonary disease (COPD) and chronic heart failure (CHF) in elderly smokers. COPD and CHF are frequently associated with concomitant chronic diseases.

A new study published in Respiration investigated similarities and differences in the clinical presentation, concomitant chronic diseases, and risk factors for mortality and hospitalization at 3-year follow-up, in elderly smokers and ex-smokers with a primary diagnosis of COPD or CHF recruited and followed in specialized centers.

This study enrolled 144 patients with COPD and 96 with CHF, 65 years of age or above, who smoked 20 or more packets of cigarettes per year. All patients were examined and they underwent COPD Assessment Test (CAT) score, modified Medical Research Council, NYHA and Charlson Index, routine blood test, estimated glomerular filtration rate, HRCT scan, and 6-min walk test (6-MWT).

The results showed that COPD and CHF patients had mild to moderate disease and most patients were symptomatic. However, comorbidities were highly prevalent and often unrecognized in both the groups. COPD and CHF patients elicited comparable 3-year risk of hospitalization and death. Meanwhile, lower glomerular filtration rate, shorter 6-MWT, and ascending aorta calcification score ≥2 were independent predictors of mortality in COPD, and previous hospitalizations within the past 12 months, renal disease, and heart diameter were independent predictors of mortality in CHF patients. Furthermore, lower glomerular filtration rate, higher CAT score, and lower FEV1/FVC ratio were associated with hospitalization in COPD patients while age, lower FEV1% predicted, and peripheral vascular disease increased the hospitalization rate in CHF patients.

The findings suggested that relevant similarities and differences exist between patients with COPD and CHF even when they are admitted to specialized outpatient centers, hence, these patients should be managed through a multidisciplinary approach.