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Cardioselective ��1-blockers are considered to be safe in COPD patients, but cardiovascular safety of ��2-agonists is disputable.6,7 Therefore, an optimal treatment regimen must be carefully determined to balance positive and negative treatment effects in patients with COPD and HF. Knowledge of chances of concurrent COPD and HF facilitates the decision on additional testing in daily practice. This review aims to highlight HF prevalence in COPD patients, and vice versa, with a critical analysis of performed studies. First, definition, diagnosis and prevalence of COPD and of HF will be discussed separately. Subsequently, an overview of important studies concerning combined prevalence will be presented and limitations discussed. We will end with pathogenic mechanisms, diagnostic considerations in clinical practice and conclusions. In the latest American Thoracic Society/European Respiratory Society Pictilisib nmr position paper, COPD is defined as a condition characterized by a not fully reversible airflow limitation, indicated by a post-bronchodilator FEV1/FVC VE-821 nmr Obstructive Lung Disease (GOLD) criteria.9 Patients usually have symptoms of dyspnoea, cough and/or sputum production and a history of exposure to risk factors, mainly tobacco smoke.8,9 Estimates of prevalence of COPD depend on diagnostic criteria and definitions used.10 In addition, spirometric cut-off points have changed over time.11 Even since the latest guidelines, gender- and age-specific cut-off points for FEV1/FVC instead of a fixed ratio are proposed and have shown essential different results.12 Also, other approaches have been used to assess COPD prevalence, for example, self-reported diagnosis (��Has a doctor ever told you that you had chronic bronchitis/emphysema?��).1 From the described prevalence studies, we have seen that spirometric assessment resulted in higher prevalence numbers than self-reported diagnosis of COPD.1,11 Furthermore, women do report to have COPD more often than men despite lower prevalence according to spirometry.1 The larger spirometry-determined, compared to self-reported, COPD prevalence might origin from irreversible Azastene airflow limitation associated with bronchiectasis, cystic fibrosis and fibrosis due to tuberculosis.8 Furthermore, discrimination between asthma and COPD can be difficult and additional tests might be required (http://www.ginasthma.com).13 On the other hand, patients with a clinical diagnosis of COPD were found to have COPD according to pulmonary function tests in only 61% (general practice) and 71% (tertiary care).3,14 Also, underpresentation, underdiagnosis or misclassification may play a role.13 Clearly, spirometry is essential for COPD diagnosis. Although, even in a tertiary care setting, spirometry was performed in only 31% of COPD patients over the past 8 years.