The Takeaway Chronic inflammation and low oxygen levels from bronchiectasis can lead to serious heart issues, including pulmonary hypertension, right-sided heart failure, and an increased risk of stroke and coronary heart disease. People with bronchiectasis often face muscle wasting (sarcopenia) as the body diverts nutrients to the lungs, while long-term use of certain steroids can significantly increase one’s risk of bone loss and osteoporosis. A high percentage of patients experience anxiety and depression due to the constant threat of breathlessness, chronic fatigue, and social isolation, which can create a cycle that worsens disease severity. The disease can also cause unintentional weight loss due to nausea and loss of appetite, as well as “brain fog” and a higher long-term risk of cognitive decline and dementia.
If you have non-cystic fibrosis bronchiectasis, you’re likely an expert on the “lung side” of the disease — the stubborn mucus, the nagging cough, and the constant threat of a flare-up. But by causing low oxygen levels and chronic inflammation , bronchiectasis can affect your heart, bones, and even your mind and mood. Learn about the various complications of bronchiectasis and how to work with your doctor to best manage them.
Resources We Trust Cleveland Clinic: Bronchiectasis American Journal of Managed Care: Complications Associated With Bronchiectasis National Heart, Lung, and Blood Institute: Living With Bronchiectasis American Lung Association: Treating and Managing Bronchiectasis European Lung Foundation: Bronchiectasis Self-Care Guide
Cardiovascular Issues Cardiovascular Issues When bronchiectasis damages your airway, it can lower oxygen levels in your blood, which causes the blood vessels in your lungs to tighten. Over time, this response can lead to pulmonary hypertension (high blood pressure in the lungs), which affects 33 to 40 percent of people with bronchiectasis. That extra pressure forces the right side of the heart to work harder to push blood through the lungs. If this strain continues for years, it can lead to right-sided heart failure.e60dc2a1-f33c-4a05-9b50-8e3e8e59762937df33a8-d273-478a-8cac-4bb8b26cb570 Bronchiectasis can also significantly increase your risk of coronary heart disease and stroke , which is even greater during flare-ups.e60dc2a1-f33c-4a05-9b50-8e3e8e597629c19520fd-27be-4d0d-9957-e9aefbb1e74d Preventing lung damage with consistent airway clearance and medication is a vital part of protecting your overall cardiovascular health.e60dc2a1-f33c-4a05-9b50-8e3e8e597629c19520fd-27be-4d0d-9957-e9aefbb1e74d At your next checkup, consider asking your doctor for a cardiovascular screening to ensure your heart is staying as healthy as your lungs.
Unintentional Weight Loss Weight Loss Unintentional weight loss can occur because bronchiectasis keeps the body in an “unrelenting inflammatory state,” says Mahajan. He compares it to how you feel when you have a fever or an upper respiratory infection with lots of inflammation. “You tend to just not be hungry. You don’t feel like eating,” he says. “That’s a constant for some people with bronchiectasis, and as a result, they tend to lose weight.” Additionally, the constant presence of mucus doesn’t just make breathing hard. It can lead to nausea and a further lack of interest in food, says Mahajan. If you find the numbers on the scale dropping without trying, don’t ignore it. “You’ll fall into a spiral of less activity, less energy, and continue down that spiral because you’re not eating,” says Mahajan. Talk to your doctor about how to boost your calorie and protein intake to give your body the fuel it needs to stay strong enough to stay active and clear infections.
Brain Fog and Cognitive Decline Cognitive Decline Many people with bronchiectasis describe experiencing a persistent “cloudiness” — trouble focusing, forgetting words, or feeling mentally slow. While poor sleep and fatigue can play a role, chronic inflammation, low oxygen levels (hypoxemia), reduced lung function, and depression may also affect brain health. In the short term, cognitive decline can show up as brain fog, difficulty concentrating, low mood, anxiety, and even feeling more shortness of breath. People with bronchiectasis who have more trouble with memory and thinking often also have worse lung function, lower oxygen levels, and more depressive symptoms.e60dc2a1-f33c-4a05-9b50-8e3e8e597629a2101cc1-9d9d-4e06-b165-8bcda597c9c7 Over the long term, bronchiectasis is linked to a higher risk of dementia , including Alzheimer’s disease , with one large study showing about a 1.6 times greater risk compared with people without the condition.e60dc2a1-f33c-4a05-9b50-8e3e8e59762985679f2b-7af4-4c8d-b11d-d61c726f9685
Muscle Loss Muscle Loss Advanced bronchiectasis can lead to muscle loss or muscle wasting (sarcopenia), says Panagis Galiatsatos, MD , national spokesperson for the American Lung Association and assistant professor at the Johns Hopkins School of Medicine in Baltimore. “Because the lungs require so much attention to do what they do, they steal all these nutrients from surrounding muscles, so there’s muscle wasting,” he says. Since daily exercise is often challenging with bronchiectasis, you may also be less active. “As a result, your body can get deconditioned [and lose muscle],” says Amit “Bobby” Mahajan, MD , national medical spokesperson for the American Lung Association and system chief of interventional pulmonology at Inova Health System in Virginia. “We really try to get to the point where people are doing good airway clearance and get pulmonary rehab to keep their muscles strong and have energy,” he says.
Bone Loss Bone Loss While medical guidelines recommend inhaled corticosteroids only for people with bronchiectasis who also have asthma , chronic obstructive pulmonary disease (COPD) , or allergic bronchopulmonary aspergillosis , many people are still prescribed them. A 2025 study using the European Bronchiectasis Registry found that nearly one-third of patients with bronchiectasis use these steroids even when they don’t meet the standard criteria.e60dc2a1-f33c-4a05-9b50-8e3e8e597629fe8e7527-4f9c-4336-bc5f-0ba300db73f8 Long-term steroid use is a known risk factor in osteoporosis . Steroids increase the breakdown of bone and inhibit the formation of new bone tissue, and the longer you take steroids (and at higher doses), the bigger your risk.e60dc2a1-f33c-4a05-9b50-8e3e8e59762903954529-5ac7-4142-b279-1316d777db42 Over time, bone density loss may also lead to an increased risk of fractures. “A lot of patients get steroids over and over again, and that can lead to bone density loss,” says Dr. Galiatsatos. Talk to your doctor about whether you need to be screened for osteoporosis, depending on your age and use of glucocorticoids.
Anxiety and Depression Mental Health Bronchiectasis can also impact your mental health, with one study suggesting that more than 65 percent of people with non-cystic fibrosis bronchiectasis have depression and nearly 55 percent have anxiety .e60dc2a1-f33c-4a05-9b50-8e3e8e5976293b214ec8-d16e-4a75-bac1-acf977d89378 It’s completely normal to feel on edge when you have a condition that “could rob you of your breathing at any point in time,” says Galiatsatos. “But if the anxiety continues to progress where it’s keeping you from really doing well, then we could talk about bringing in mental health specialists.” Because of chronic fatigue and breathlessness, many people with bronchiectasis also isolate themselves, which can increase feelings of depression. Dr. Mahajan says some “close themselves off from society” because they’re afraid of catching an infection, coughing in public, or simply not being able to keep up with others. If bronchiectasis is taking a mental health toll, talk to your pulmonologist. Left unaddressed, anxiety and depression can lead to more flare-ups and hospitalizations, as well as stronger disease severity and lower quality of life.e60dc2a1-f33c-4a05-9b50-8e3e8e597629ffb11294-690e-4d34-99a6-d0a9cf981000
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