COMPARING DRUG THERAPIES AND DIETARY INTERVENTIONS FOR COPD AND HEART FAILURE

Abstract

Background: Chronic obstructive pulmonary disease (COPD) and heart failure (HF) often coexist, presenting complex clinical challenges and compounded morbidity. Pharmacologic therapies remain the mainstay of treatment, yet dietary interventions have shown emerging potential in improving outcomes. However, direct comparisons between these approaches in COPD-HF populations remain limited.

Objective: To compare the clinical efficacy of standard drug therapies versus structured dietary interventions in patients with concurrent COPD and heart failure.

Methods: This randomized controlled trial was conducted over eight months at two tertiary care centers. A total of 160 patients with moderate-to-severe COPD and NYHA class II–III heart failure were randomized into two groups: pharmacological therapy (n=80) and dietary intervention (n=80). The primary outcomes included changes in six-minute walk distance (6MWD), modified Medical Research Council (mMRC) dyspnea scale, and NT-proBNP levels. Secondary outcomes included quality of life measures (SGRQ, KCCQ), exacerbation frequency, and hospitalization rates. Data were analyzed using independent t-tests and repeated measures ANOVA.

Results: The dietary group showed significantly better improvement in 6MWD (402±44 m vs. 380±48 m, p=0.022), mMRC score (2.0±0.5 vs. 2.3±0.6, p=0.017), and NT-proBNP levels (912±193 pg/mL vs. 985±214 pg/mL, p=0.034). Quality of life scores also favored dietary intervention (SGRQ: 42.0±8.8 vs. 45.2±9.6; KCCQ: 64.7±9.1 vs. 61.5±8.4). There were fewer exacerbations and hospitalizations in the dietary group, though the latter was not statistically significant.

Conclusion: Dietary interventions, when supported with structured counseling, offer a viable and potentially superior alternative to drug therapies in managing patients with coexisting COPD and HF, suggesting a shift toward integrative, lifestyle-centered care approaches.