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Cardiovascular morbidity and mortality in COPD
Laetitia Huiart1, Pierre Ernst, Samy Suissa
1Division of Clinical Epidemiology, Royal Victoria Hospital and Department of Epidemiology and Biostatistics, McGill University, 687 Pine Ave West, Ross 4.29, Montreal, QC, Canada, H3A 1A1.
Insights
Patients with chronic obstructive pulmonary disease (COPD) have a higher risk of cardiovascular disease (CVD) hospitalization and death compared to the general population. CVD may pose a greater health burden than COPD itself.
Area of Science:
- Pulmonary Medicine
- Cardiology
- Epidemiology
Background:
- Chronic obstructive pulmonary disease (COPD) and cardiovascular disease (CVD) share common risk factors.
- Understanding the comparative burden of CVD in COPD patients is crucial for comprehensive patient management.
Purpose of the Study:
- To estimate and compare hospitalization and mortality rates for CVD in COPD patients versus the general population.
- To identify specific CVDs contributing significantly to morbidity and mortality in COPD.
Main Methods:
- A cohort of 5,648 patients aged 55+ receiving initial COPD treatment (1990-1997) was identified from Saskatchewan Health databases.
- Hospitalizations and deaths were tracked through 1999, generating 23,426 person-years of follow-up.
- Standardized rate ratios were calculated to compare COPD patients with the general population.
Main Results:
- COPD patients exhibited higher rates of cardiovascular morbidity (177.2/1000 PY) and mortality (41/1000 PY) compared to the general population (SRRs of 1.9 and 2.0, respectively).
- Cardiovascular disease hospitalizations exceeded those for COPD.
- Heart failure was the most frequent CVD hospitalization cause, while ischemic heart disease was a more common cause of death than COPD.
Conclusions:
- Cardiovascular disease is significantly more prevalent in COPD patients than in the general population.
- The health burden of CVD in COPD patients may surpass that of the lung disease itself.
- Highlights the need for integrated management of COPD and cardiovascular conditions.
Study Objective:
COPD and cardiovascular disease (CVD) share common risk factors. We undertook to estimate rates of hospitalization and death from CVD in COPD patients relative to the general population.
Design And Setting:
A cohort of patients > or = 55 years old receiving a first treatment for COPD between 1990 and 1997 was formed from the Saskatchewan Health databases. All hospitalizations and deaths between cohort entry and the end of 1999 were identified.
Results:
The cohort included 5,648 individuals and generated 23,426 person-years (PY) of follow-up. The overall rates of cardiovascular morbidity and mortality were 177.2 and 41 per 1,000 PY, respectively. Cardiovascular morbidity and mortality rates were higher in the COPD cohort than in the general population (standardized rate ratios of 1.9 and 2.0, respectively). More hospitalizations for CVD than for COPD itself were reported. Among CVDs, heart failure represented the most frequent cause of hospitalization (58.8 per 1,000 PY). CVD and more specifically ischemic heart disease (19.6 per 1,000 PY) were reported as a more frequent cause of death than COPD itself (15.5 per 1,000 PY).
Conclusion:
CVD is more frequent in COPD patients than in the general population and may represent a burden greater than that of lung disease itself.
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