A healthcare professional is educating a patient about asthma. The professional states that good control is necessary due to which pathophysiologic process?

A. Controlling the blood pressure: Controlling blood pressure is crucial for reducing the risk of developing coronary artery disease (CAD). Even with a normal lipid panel, hypertension can significantly contribute to cardiovascular risk, and managing blood pressure helps protect against the development of CAD.

B. Moderate alcohol use: While moderate alcohol consumption may have some potential benefits for heart health, it is not a primary risk factor reduction strategy. The focus should be on more impactful lifestyle changes, particularly for individuals with normal lipid levels.

C. Eating a low-fat diet: Although a balanced diet is important for overall health, a low-fat diet specifically is not necessary for everyone, especially those with normal lipid levels. The emphasis should be on a heart-healthy diet that includes healthy fats, such as those from fish, nuts, and olive oil, rather than simply reducing fat intake.

D. Avoiding air pollution: Avoiding air pollution can have health benefits, but it is not a primary strategy for individuals seeking to reduce the risk of CAD. Addressing more direct risk factors, such as blood pressure management, is more critical in this context.

A. Left heart failure: COPD primarily affects the lungs and increases pulmonary vascular resistance, leading to right-sided heart strain rather than left heart failure. Left heart failure is more commonly associated with conditions such as hypertension, myocardial infarction, and valvular diseases, which impair the heart’s ability to pump blood systemically.

B. Restrictive cardiomyopathy: Restrictive cardiomyopathy is a condition where the heart muscle becomes stiff and loses its ability to relax and fill properly, often due to infiltrative diseases such as amyloidosis or sarcoidosis. COPD does not directly lead to restrictive cardiomyopathy, as its primary cardiovascular complication is increased pulmonary resistance causing right heart strain.

C. Hypertrophic cardiomyopathy: Hypertrophic cardiomyopathy is characterized by abnormal thickening of the heart muscle, usually due to genetic mutations. It primarily affects the left ventricle and impairs diastolic filling. COPD does not cause hypertrophic cardiomyopathy, as its cardiovascular effects are due to pulmonary hypertension and right ventricular overload rather than structural abnormalities of the myocardium.

D. Right heart failure: Chronic COPD leads to persistent pulmonary hypertension due to hypoxic vasoconstriction and remodeling of pulmonary vessels. This increased pulmonary vascular resistance forces the right ventricle to work harder to pump blood into the lungs, leading to right ventricular hypertrophy and eventual right heart failure, also known as cor pulmonale. Symptoms include peripheral edema, jugular vein distention, and hepatomegaly due to systemic venous congestion.