[en] Introduction: Chronic obstructive pulmonary disease (COPD) represents a major health and economic challenge in Belgium, affecting approximately 800,000 individuals, half of whom remain undiagnosed. Beyond respiratory morbidity, COPD patients face substantial cardiopulmonary (CP) risk-encompassing severe exacerbations and cardiovascular (CV) events-that is often underrecognized and insufficiently addressed due to limited clinical awareness, fragmented care, and the absence of national guidance. Methods: A multidisciplinary Belgian taskforce (general practitioners, pulmonologists, cardiologists, pharmacists, epidemiologists) convened through structured workshops and iterative consensus-building to develop a pragmatic, evidence-informed care pathway. The recommendations focus on COPD patients with at least one moderate or severe exacerbation, who are at heightened CP risk. Results: This consensus introduces an integrated, stepwise framework that positions CP risk as a central component of COPD management after exacerbation and operationalizes it across primary care, hospitalization, and post-exacerbation follow-up. Core elements include systematic and proactive CP risk identification in primary care, standardized diagnostic workups during hospitalization, and multidisciplinary discharge planning. Pharmacological strategies combine eosinophil-guided inhaler therapy with guidelinedirected CV treatment, while non-pharmacological measures reinforce smoking cessation, vaccination, physical activity, and pulmonary rehabilitation. Clear referral thresholds between primary care, pulmonology, and cardiology are defined, supported by patient education and digital monitoring tools. Conclusion: This Belgian consensus complements international guidelines by consolidating fragmented recommendations into coherent, actionable algorithms that bridge gaps in routine practice. Its contribution lies in translating emerging evidence into structured, real-world pathways that integrate respiratory and cardiac care. Adoption of this framework may help reduce exacerbations, improve CV outcomes, and support multidisciplinary COPD care in Belgium.
Disciplines :
General & internal medicine
Author, co-author :
Michotte, Naomi ; Department of Respiratory Medicine, Universitair Ziekenhuis Brussel, Brussels, Belgium ; Lung Research Unit, Vitality Research Group, Vrije Universiteit Brussel, Brussels, Belgium
Demeure, Fabian; Department of Cardiology, CHU UCL Namur, Yvoir, Belgium
Guiot, Julien ; Université de Liège - ULiège > Département des sciences cliniques > Pneumologie - Allergologie
Trenson, Sander; Department of Cardiology, AZ Sint-Jan, Bruges, Belgium
Vanfleteren, Michiel; Department of Respiratory Medicine, Sint-Josefskliniek, Izegem, Belgium
Lahousse, Lies ; Department of Bioanalysis, Ghent University, Gent, Belgium ; Department of Epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands
Raskin, Jo; Department of Pulmonology and Thoracic Oncology, Antwerp University Hospital, Edegem, Belgium ; Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
Cataldo, Didier ; Université de Liège - ULiège > Département des sciences biomédicales et précliniques > Biochimie et physiologie générales, humaines et pathologiques
Lapperre, Thérèse; Department of Respiratory Medicine, Antwerp University Hospital, Antwerp, Belgium ; Laboratory of Experimental Medicine and Pediatrics, University of Antwerp, Antwerp, Belgium
Marchand, Eric; Department of Respiratory Medicine, CHU-UCL Namur, Yvoir, Belgium ; Namur Research Institute for Life Sciences (NARILIS), University of Namur, Namur, Belgium
Leys, Mathias; Department of Respiratory Medicine, AZ Groeninge, Kortrijk, Belgium
Janssens, Wim ; Department of Respiratory Medicine, University Hospital of Leuven, Leuven, Belgium
Bruyneel, Marie ; Department of Respiratory Medicine, CHU Saint-Pierre, Brussels, Belgium ; Department of Respiratory Medicine, CHU Brugmann, Brussels, Belgium
Vanfleteren, Lowie; Department of Respiratory Medicine, Ghent University Hospital, Ghent, Belgium ; Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
Vanderhelst, Eef; Department of Respiratory Medicine, Universitair Ziekenhuis Brussel, Brussels, Belgium ; Lung Research Unit, Vitality Research Group, Vrije Universiteit Brussel, Brussels, Belgium
Goeminne, Pieter; Department of Respiratory Medicine, VITAZ Hospitals, Sint-Niklaas, Belgium
Teughels, Stefan; Domus Medica, Antwerp, Belgium
Lins, Muriel; Department of Respiratory Medicine, AZ Sint-Maarten, Mechelen, Belgium
Van Rossem, Inès; Department of Family Medicine and Chronic Care, Vrije Universiteit Brussel, Brussels, Belgium
Peché, Rudi ; Department of Respiratory Medicine, CHU Charleroi, Humani Network, Charleroi, Belgium
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