Treating Hypertension in Chronic Obstructive Pulmonary Disease

This comprehensive review explores the complex intersection of chronic obstructive pulmonary disease (COPD) and systemic hypertension, which frequently co-occur and share overlapping pathophysiologic mechanisms like systemic inflammation and endothelial dysfunction. The authors analyze the cardiovascular risks posed by both conditions and detail contemporary evidence regarding antihypertensive drug classes and their effects on pulmonary health. Recommendations emphasize thiazides, ACE inhibitors, ARBs, and calcium-channel blockers as generally safe initial therapies, with diuretics and RAAS-targeting agents playing key roles. Cautions are outlined for loop diuretics and noncardioselective beta-blockers due to potential respiratory exacerbations. The review advocates tailored pharmacologic strategies based on comorbidities such as heart failure or coronary artery disease, and highlights drug–disease and drug–drug interactions relevant to pulmonary control. Monitoring of pulmonary function and blood pressure remains central to optimizing outcomes.

This comprehensive review explores the complex intersection of chronic obstructive pulmonary disease (COPD) and systemic hypertension, which frequently co-occur and share overlapping pathophysiologic mechanisms like systemic inflammation and endothelial dysfunction. The authors analyze the cardiovascular risks posed by both conditions and detail contemporary evidence regarding antihypertensive drug classes and their effects on pulmonary health. Recommendations emphasize thiazides, ACE inhibitors, ARBs, and calcium-channel blockers as generally safe initial therapies, with diuretics and RAAS-targeting agents playing key roles. Cautions are outlined for loop diuretics and noncardioselective beta-blockers due to potential respiratory exacerbations. The review advocates tailored pharmacologic strategies based on comorbidities such as heart failure or coronary artery disease, and highlights drug–disease and drug–drug interactions relevant to pulmonary control. Monitoring of pulmonary function and blood pressure remains central to optimizing outcomes.