Daily Aspirin Might Ease COPD Flare-Ups

Steven Reinberg wrote . . . . . . . . .

Many Americans take a daily low-dose aspirin to protect their hearts. Now it appears aspirin may also reduce flare-ups of chronic obstructive pulmonary disease (COPD).

In a study of COPD sufferers, researchers found that aspirin was linked to fewer moderate exacerbations, but not severe bouts, of the lung disease. It also reduced moderate and severe episodes of labored breathing.

“This study highlights that adding aspirin to current treatment regimens may potentially improve the well-being of patients suffering from a burdensome chronic disease while reducing health care utilization,” said lead researcher Dr. Ashraf Fawzy. He is a pulmonary and critical care fellow at Johns Hopkins University in Baltimore.

However, Fawzy said more research is needed before broadly recommending that patients start taking aspirin as part of their COPD treatment.

The study was funded by the U.S. National Institutes of Health. Fawzy and his colleagues looked at nearly 1,700 people with COPD. About 45 percent of participants reported regularly taking low-dose aspirin at the start of the study. (Low-dose aspirin is generally 81 milligrams.)

The researchers found the aspirin users had fewer flare-ups over three years.

Patients also reported better quality of life and less shortness of breath, compared with patients who did not use aspirin, according to the study.

COPD includes bronchitis and emphysema, two chronic lung diseases. Smoking is its main cause, but long-term environmental exposure to toxic dust or chemicals is another culprit.

Millions of Americans suffer from COPD, and it is the third leading cause of disease-related death in the nation, according to the American Lung Association.

There is treatment but no cure. Medications usually include a bronchodilator that opens the airways, making it easier to breathe, and an anti-inflammatory. In the most severe cases, patients need a constant supply of oxygen.

Aspirin has already shown a benefit in preventing heart attacks and strokes in patients with cardiovascular disease, but its role in COPD has been unclear.

However, because this study can’t actually prove that aspirin caused the reduction in flare-ups, experts aren’t ready to make a general recommendation about aspirin use for COPD.

“It’s really too early to say,” said Dr. Alan Mensch, senior vice president for medical affairs at Plainview and Syosset Hospitals in Long Island, N.Y.

“COPD is a chronic condition where we really have limited options to treat patients,” said Mensch, who wasn’t involved in the new research.

Although new treatments would be welcome, he said it’s hard to tell from this study if aspirin really reduced flare-ups.

That’s because it was what’s called an observational study. Researchers compared patients who self-reported they did or didn’t take aspirin, but weren’t randomly assigned to one group or the other.

Fawzy added that “a randomized controlled trial of aspirin use in patients with COPD is warranted to rigorously assess whether aspirin is beneficial in this patient population.”

One problem in comparing COPD patients is that many suffer from other conditions. Most COPD patients, for example, also have cardiovascular disease, Mensch pointed out.

However, he noted that other studies have found aspirin may extend the life of COPD patients and slow the progression of emphysema. “It may help,” Mensch said.

So how exactly might aspirin work its magic? Mensch noted aspirin is an anti-inflammatory, which might explain the reduction in COPD flare-ups.

The report appears in the journal Chest.

Source: HealthDay

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Rheumatoid Arthritis Linked to an Increased Risk of COPD

New research suggests that rheumatoid arthritis may increase the risk of developing chronic obstructive pulmonary disease (COPD). The findings, which appear in Arthritis Care & Research, indicate that greater vigilance may be needed to protect the respiratory health of individuals with chronic inflammatory conditions.

Research has demonstrated an association between COPD and inflammation, raising the question of whether prolonged inflammatory conditions such as rheumatoid arthritis predispose individuals to COPD. To investigate, a team led by Diane Lacaille, MD, FRCPC, MHSc, of Arthritis Research Canada and the University of British Columbia, examined information on individuals in the province of British Columbia who were diagnosed with rheumatoid arthritis between 1996 and 2006, and compared it with information on matched individuals in the general population. The analysis included 24,625 patients with rheumatoid arthritis and 25,396 controls.

The investigators found that the incidence of COPD hospitalization was greater in patients with rheumatoid arthritis than in the general population. After adjusting for potential confounding factors, individuals with rheumatoid arthritis had a 47% greater risk of needing to be hospitalized for COPD than controls. The increased risk remained significant after modelling for smoking and with varying COPD definitions.

“These findings are novel because it has only recently been recognized that inflammation plays a role in the development of COPD, and clinicians treating people with rheumatoid arthritis are not aware that their patients are at increased risk of developing COPD,” said Dr. Lacaille. “Our results emphasize the need to control inflammation, and in fact to aim for complete eradication of inflammation through effective treatment of rheumatoid arthritis.”

Dr. Lacaille added that clinicians and people living with rheumatoid arthritis should be vigilant in watching for early symptoms of COPD. “That way, appropriate tests can be administered to diagnose COPD early, at the onset of symptoms, so that effective treatments for COPD can be initiated before irreversible damage to the lungs occurs.” Such steps will improve long-term outcomes for patients and reduce the costs of COPD. The study also points to the need to address COPD risk factors — such as smoking — in people living with rheumatoid arthritis.

Source: Science Daily

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Statins May Help People With Lung-related Disease Live Longer

Serena Gordon wrote . . . . . .

Drugs known as statins may have benefits beyond lowering “bad” LDL cholesterol levels. A new study suggests people with chronic lung disease who take these drugs may extend their survival.

The study from Canada included nearly 40,000 people with chronic obstructive pulmonary disease (COPD). One in five patients was taking a statin, and those individuals had a 21 percent lower risk of dying from any cause, and a 45 percent reduced risk of dying from lung-related issues, the researchers found.

This study comes on the heels of a separate large-scale investigation that found no link between statin use and the number of COPD exacerbations people experienced.

“While evidence from a recently completed [randomized controlled trial] suggested that statin use is of little benefit to COPD patients, this population-based analysis showed that statin use reduced all-cause mortality among COPD patients,” wrote the study authors led by Adam Raymakers, from the University of British Columbia.

Although statins appeared to give people with COPD a survival benefit, the new study wasn’t designed to prove a definitive cause-and-effect relationship.

Chronic obstructive pulmonary disease includes progressive lung diseases such as emphysema and chronic bronchitis, according to the COPD Foundation. Symptoms include increasing breathlessness, tightness in the chest, coughing and wheezing.

The most common causes for these conditions include smoking and exposure to secondhand smoke. Workplace exposure to chemicals and fumes and genetics may also contribute to COPD.

It’s the third leading cause of death in the United States, according to the U.S. National Heart, Lung, and Blood Institute. Approximately 16 million Americans have been diagnosed with the condition, but many people may have it without knowing it.

Raymakers and his team noted that it’s long been known that people with COPD have inflammation in their lungs. However, it’s also possible that people with COPD — or at least some of them — may have inflammation throughout their body. Inflammation is thought to play a role in many illnesses, including heart disease.

The participants were age 50 and older from British Columbia. The researchers identified people as having COPD if they had received at least three prescriptions for COPD medications in a 12-month period.

The study team then looked to see who was also taking a statin within a year of being labeled as having COPD. Almost 20 percent had received at least one statin prescription.

The researchers adjusted the data to account for a number of factors including age, sex, income and place of residence.

There were almost 1,450 deaths during the one-year study period.

The findings were published in the journal Chest.

Dr. Robert Reed, an associate professor at the University of Maryland School of Medicine, co-authored an accompanying editorial. “Although this is not a perfect paper, it’s really well done, and it showed this benefit to mortality,” he said.

Reed noted that some in the study may not have had COPD.

“They took people who hadn’t been on an inhaler the year before who now had a cough or shortness of breath. That could be a lot of things. They almost certainly had some late-onset asthmatics. People may have even been short of breath for cardiac reasons,” he explained.

“People with COPD have more cardiovascular disease, and treating comorbid [coexisting] conditions can really help out. The survival benefit may not be unique to COPD, but it was a pretty significant survival benefit for people with COPD,” Reed said.

Dr. Len Horovitz, a pulmonary specialist at Lenox Hill Hospital in New York City, said that although study participants got a prescription for statins, it doesn’t necessarily mean they took the drugs.

“There might be a subset of COPD patients who might benefit from statin use who don’t need a statin for cardiovascular reasons, but the heart and lungs are intertwined, and it’s hard to tease out someone with COPD who doesn’t have risk factors for cardiovascular disease,” Horovitz said.

Because most people with COPD are smokers or former smokers, he said, most also have cardiovascular disease. “And that cardiovascular disease is usually reason enough to prescribe the statin,” he added.

Source: HealthDay

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Healthy Diet May Be Linked to Lower Risk of Lung Disease

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A healthy diet low in red meat and rich in whole grains might reduce the risk of developing the crippling chronic lung disease known as COPD (Chronic Obstructive Pulmonary Disease), new research suggests.

Researchers tracked more than 120,000 men and women and found healthy eaters were one-third less likely to develop COPD compared to big consumers of red meat, refined grains, sugary drinks and alcohol.

“The predominant risk factor for COPD in the developed world is cigarette smoking,” said study lead author Raphaelle Varraso, a researcher with the unit of aging and chronic diseases at the National Institute of Health and Medical Research in Villejuif, France.

“But up to one-third of COPD patients have never smoked, suggesting that other factors are involved,” Varraso said. “This novel finding supports the importance of diet in COPD development.”

The study was published online in the British Medical Journal.

The finding builds on a wide body of prior research suggesting that a healthy diet lowers the risk for heart disease and cancer. And good eating habits seem to lower COPD risk for both smokers and nonsmokers alike, the researchers found.

COPD is an umbrella term for several chronic lung diseases, including emphysema and bronchitis, that lead to blocked air passages and restricted oxygen flow. Routine breathing can be difficult and painful for someone with COPD — the third leading cause of death in America, according to the American Lung Association.

To explore the impact of diet on COPD risk, the investigators focused on the health and eating habits of more than 73,000 women who participated in the U.S. Nurses’ Health Study between 1984 and 2000. They also looked at the nutrition profiles of over 47,000 men enrolled in the Health Professionals Follow-Up Study between 1986 and 1998.

Most of the participants were white, and all worked as health professionals.

By the end of each study’s time frame, 723 women and 167 men developed COPD. The subsequent analysis indicated that COPD risk was far lower among those whose diets were light on red meat, sweetened drinks and alcohol, and rich in vegetables, complex carbohydrates such as green vegetables and whole grains, and polyunsaturated fats and nuts.

Polyunsaturated fats include soybean, safflower, corn and canola oils, and fish such as salmon, trout and herring.

The finding that a healthy diet was independently related to lower COPD risk appeared to hold up even after accounting for other factors, including smoking history, age, race, exercise habits and being overweight.

Nevertheless, Varraso cautioned against concluding that diet has a direct impact on COPD risk, given that the study participants were medical professionals with a presumably greater focus on health and healthy behavior than the general public. However, the findings underscore the need for more research into how eating patterns affect lung health, Varraso suggested.

“Although COPD prevention efforts should continue to focus on smoking cessation, our results encourage clinicians to consider the potential role of the combined effect of foods in a healthy diet in promoting lung health,” said Varraso.

Lona Sandon, an assistant professor of clinical nutrition at the University of Texas Southwestern Medical Center at Dallas, called the findings “reasonable.”

“As always, we need to keep in mind that this type of study suggests potential causes or factors, but does not prove cause,” she noted. She also stressed that healthy eaters are also more likely to engage in other healthy behaviors.

“With that said, a healthy diet pattern has been connected with decreasing risk of several other chronic diseases that develop over an extended period of time,” said Sandon. “So why should it be any different with COPD?”

Source: U.S. Department of Health and Human Services

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