TABLE 2.

Common comorbidities in chronic obstructive pulmonary disease (COPD)

Comorbidity	Effect/associations of comorbidity in COPD	Treatment	[Ref.]
Ischaemic heart  disease	Increased mortality	β-blocker, ACE-I, aspirin, statin, nitrates	[32, 33]
Congestive cardiac  failure	Increased symptom burden, increased mortality	As above, plus diuretics Digoxin and implantable devices may be used in some patients	[32, 34]
Anxiety	Poor HRQoL, increased mortality, increased hospital admissions	CBT, benzodiazepines, exercise	[35–37]
Depression	Poor HRQoL, increased mortality, increased hospital admissions	CBT, anti-depressants, exercise	[37–39]
Osteoporosis	Reduced physical performance, poor lung function	Calcium supplements, bisphosphonates	[40–44]
GORD	More frequent exacerbations	PPI, H2 receptor antagonist	[45–47]

This is not an exhaustive list of all conditions or treatments; where possible, references specific to COPD, major review articles or international guidelines on management have been cited rather than single studies. GORD: gastro-oesophageal reflux disease; ACE-I: angiotensin-converting enzyme inhibitor; HRQoL: health-related quality of life; CBT: cognitive behavioural therapy, PPI: proton-pump inhibitor.