Statins in COPD - theoretical reflections

Conflict of interest: J.D.C. Hannink received an unrestricted educational grant from AstraZeneca, and the research of Y.F. Heijdra is financed by Chiesi Pharmaceuticals and Nederlands Astma Fonds. Occasionally, Y.F Heijdra is involved in teaching and lectures, which are sponsored by Glaxo-Wellcome and Actelion.

• Systemic inflammation is thought to play a role in the pathogenesis and extrapulmonary manifestations (including cardiovascular disease) of COPD.

• In addition to cholesterol-lowering properties, statins have anti-inflammatory properties, which may also have positive effects on cardiovascular morbidity and mortality.

• Therefore, it can be hypothesized that statins may play a role in prevention of COPD progression and the development of extrapulmonary manifestations of COPD.

• Statins may have positive effects on lung function decline, exacerbation frequency, exercise tolerance and mortality in COPD patients, but the evidence is weak.

• It is unclear whether these findings are the result of anti-inflammatory properties and/or of cholesterol-lowering properties in patients with (unrecognized) cardiovascular disease.