The Link Between Heart Failure and COPD

Here’s what you need to know to protect your heart health.

Chronic obstructive pulmonary disease (COPD) comes with all types of management challenges, including exercising effectively, taking prescribed medication, and coping with fatigue. COPD can also increase your risk of other chronic conditions, such as heart failure.

According to older studies cited in a 2013 research review, more than 20% of people with COPD have heart failure, and the risk of developing heart failure is 4.5 times higher for people with COPD than for people without it.

“When you have a limitation of airflow, which is one of the primary characteristics of COPD, that affects not just the lungs but also the entire body,” says Gautam Sikka, MD, a pulmonologist at UTHealth Houston. “Because there is damage to airway passages, that can lead to increased inflammation as well as difficulty getting adequate oxygen, and both of those factors can affect the cardiovascular system.”

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Facts about heart failure and COPD

According to a 2021 research review, inflammation and insufficient oxygen intake can make COPD progressive, which means you may not realize it’s affecting your heart function until you have symptoms.

The review’s authors mention that COPD and heart failure can have similar symptoms. You might chalk up early stage heart problems to an ongoing issue related to your COPD.

Whether you have COPD and are concerned about developing heart issues or you’re a caregiver for someone living with COPD, here’s what you need to know about this connection, along with tips that may help prevent heart failure and other heart health concerns.

When considering the relationship between COPD and heart failure, here are some key facts from recent research:

• Heart failure can be stealthy: Some research suggests that heart failure in people living with COPD is under-investigated and under-treated. For example, you might not receive a heart failure diagnosis until you’re in the hospital for a COPD-related exacerbation.
• Inadequate COPD management can raise your heart health risk: The same research notes that COPD exacerbations can lead to a greater risk of developing heart failure. You might have lower oxygen levels and more inflammation, which can negatively affect your heart.
• When you have both conditions, treatment gets more complicated: Research suggests that when someone has both COPD and heart failure, both conditions become more challenging to treat. For example, treatments for heart failure may negatively affect COPD, such as by giving you more fatigue when that’s already a big concern. And beta-blockers, a major treatment for heart failure, may worsen COPD.

When combined, heart failure and COPD can make each other worse. That’s why it’s essential to focus on heart health as part of your treatment plan.

Symptoms of heart failure with COPD

It’s important to recognize the symptoms of heart failure since they may overlap with COPD symptoms, says Sikka. Here’s what you may experience if heart issues are becoming a concern:

• shortness of breath that doesn’t improve with rest and is worse when lying down
• cough or chest discomfort wakes you up at night
• swelling in your legs, ankles, and feet
• muscle weakness
• a rapid or irregular heartbeat
• wheezing, especially during activity
• weight gain as a result of excess fluid buildup in your tissues
• confusion or difficulty thinking

Even if you’re experiencing just a few of these — or even one — it’s a good idea to check in with your doctor since you may need to be screened for heart problems.

Four tips to manage heart health

If you have COPD but don’t yet have heart failure, this is a great time to make sure you’re practicing lifestyle behaviors that promote overall wellness, says Laurie Manka, MD, a pulmonologist at National Jewish Health in Colorado. She adds that what is beneficial for your heart function is nearly always good for your respiratory system.

Here are some lifestyle changes, as outlined by the National Institutes of Health, that can help you stay on top of your heart health:

1. Join a COPD self-management program, which can help you manage fatigue and learn breathing tips.
2. Follow an eating plan that meets your nutritional needs. Research suggests that ultra-processed foods can worsen inflammation and affect your immune system.
3. Get regular low impact exercise by walking, strength training, or working with a physical therapist.
4. Find ways to reduce stress, such as practicing mindfulness, building more social time into your schedule, and getting outdoors in the fresh air, if possible.

“Keep in mind that options may be available through your health system,” says Manka. “Utilize the resources you have available as much as possible.”

Navigating both conditions

If you already have a diagnosis of heart failure in addition to your COPD, you’re likely already under the care of a medical team that includes a pulmonologist and cardiologist. Sikka says these professionals can work together to manage both conditions as your COPD progresses.

“The most important aspect of managing these chronic conditions is to have a solid treatment plan that you follow closely and to let your health provider know if there are any changes, such as new symptoms or difficulty with everyday activities,” he adds.

A daily health log can be helpful because it allows you and your healthcare team to track your symptoms over time, Manka says.

For example, you may have shortness of breath when you reach the top of the stairs and, over a few weeks of tracking, realize that breathing constriction starts after only a few steps. If that happens, she says, your healthcare team may shift your treatment plan to add an option such as pulmonary or cardiac rehab or possibly both.

The lifestyle changes and treatment plan that will work best for you depend on various individual health factors, such as your age, general health status, healthcare access, and COPD progression rate. That’s why developing a tailored health plan alongside your doctor is so important.