Cardiovascular morbidity in COPD: A study of the general population
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Published on: August 24, 2019
Peter Lange1, Rasmus Mogelvang, Jacob Louis Marott
1Bispebjerg Hospital, Copenhagen, Denmark. plange@dadlnet.dk
Insights
Chronic obstructive pulmonary disease (COPD) is linked to more cardiovascular diseases in the general population. However, this association is primarily driven by older age, not lung function itself.
Area of Science:
- Cardiology
- Pulmonology
- Epidemiology
Background:
- Studies on heart disease and COPD often focus on hospitalized patients.
- Data on the prevalence of reduced lung function and impaired left ventricular ejection fraction (LVEF) in the general population are limited.
Purpose of the Study:
- To describe the relationship between COPD and cardiac conditions in the general population.
- To investigate the prevalence of reduced lung function and impaired LVEF in individuals with COPD.
Main Methods:
- Utilized data from The Copenhagen City Heart Study (5,890 participants).
- A subgroup of 3,469 individuals underwent spirometry and echocardiography.
- COPD staging was based on GOLD criteria using FEV(1).
Main Results:
- COPD prevalence was 5.7% (mild), 9.4% (moderate), and 2.5% (severe/very severe).
- Individuals with COPD were older and had more cardiovascular risk factors and diseases.
- Left ventricular hypertrophy was more frequent in COPD patients but not statistically significant after adjusting for age and gender.
Conclusions:
- COPD patients in the general population exhibit a higher prevalence of cardiovascular diseases and unfavorable risk profiles.
- These associations are largely attributable to older age rather than COPD severity or direct cardiac dysfunction.
Abstract:
Although there are a number of studies on the coexistence of heart disease and COPD among patients acutely admitted to hospital, this relationship has not been accurately described in the general population. Especially data on the prevalence of both reduced lung function and impaired left ventricular ejection fraction (LVEF) are sparse. We used data from the 4th examination of The Copenhagen City Heart Study, which comprises 5,890 individuals with data on pulmonary and cardiac symptoms, risk factors for cardiovascular diseases, pulmonary function tests, ECG and relevant medical history. Among the participants a randomly selected subgroup of 3,469 individuals underwent both spirometry and echocardiography. The participants were classified according to COPD stage using the international GOLD staging according to FEV(1) in % of predicted. The prevalence of COPD was 5.7% for mild COPD (GOLD stage 1), 9.4% for moderate COPD (GOLD stage 2) and 2.5% for severe and very severe COPD (GOLD stages 3+4). Individuals with COPD were older and had a higher prevalence of cardiovascular risk factors and a higher prevalence of cardiovascular diseases. Among the echocardiographical findings, only the presence of left ventricular hyperthrophy was significantly more frequent among individuals with COPD (17.7%) than among participants without COPD (12.1%.), yet this relationship was no longer significant after statistical adjustment for age and gender. In the general population, subjects with COPD have a higher prevalence of cardiovascular diseases and an unfavourable cardiovascular risk profile compared with individuals without COPD, but this was mainly related to higher age among the participants with COPD.
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