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Impact of non-cardiovascular disease comorbidity on cardiovascular disease symptom severity: a population-based study
1Health Services Research Unit, Keele University, England, United Kingdom.
Insights
Non-cardiovascular comorbidity, like osteoarthritis (OA), can impact physical limitations from chest pain (CP) and shortness of breath (SOB) in cardiovascular disease (CVD) patients. Interventions targeting comorbidity are needed for better CVD health outcomes.
Area of Science:
- Cardiology
- Geriatrics
- Public Health
Background:
- Non-cardiovascular comorbidities are prevalent in cardiovascular disease (CVD) populations.
- The impact of these comorbidities on symptom-specific physical limitations, such as chest pain (CP) and shortness of breath (SOB), remains unclear.
- Understanding these relationships is crucial for comprehensive patient care.
Purpose of the Study:
- To investigate the influence of non-cardiovascular comorbidity on physical limitations associated with CP and SOB in CVD patients.
- To examine how different severities of CVD interact with comorbidity to affect these limitations.
- To test the hypothesis that unrelated comorbidities worsen symptom-specific physical limitations.
Main Methods:
- A study involving 5426 patients from ten family practices.
- Patients were categorized into eight severity groups based on CVD (hypertension, ischemic heart disease, heart failure) and osteoarthritis (OA) status.
- Linear regression was used to assess associations between cohorts and physical limitations, measured by the Seattle Angina Questionnaire (CP) and Kansas City Cardiomyopathy Questionnaire (SOB).
Main Results:
- Chest pain (CP) and shortness of breath (SOB) physical limitations increased with CVD severity.
- In patients with comorbid osteoarthritis (OA), physical limitation scores for CP were lower compared to CVD patients without OA: -14.7 for hypertension, -5.5 for IHD, and -22.1 for HF.
- Similarly, SOB physical limitation scores were lower in comorbid groups: -9.2 for hypertension, -6.4 for IHD, and -8.8 for HF.
Conclusions:
- Chest pain (CP) and shortness of breath (SOB) are common symptoms in cardiovascular disease (CVD).
- Osteoarthritis (OA) comorbidity additively increases CVD symptom-specific physical limitations.
- Development of comorbidity interventions is essential for improving CVD-specific health outcomes.
Objectives:
Non-cardiovascular comorbidity is common in cardiovascular disease (CVD) populations but its influence on chest pain (CP) and shortness of breath (SOB) symptom-specific physical limitations is unknown. We wanted to test the a priori hypothesis that an unrelated comorbidity would influence symptom-specific physical limitations and to investigate this impact in different severities of CVD.
Method And Results:
The study was based on 5426 patients from ten family practices, organised into eight a priori exclusive severity groups: (i) no CVD or osteoarthritis (OA) (reference), (ii) index hypertension, ischaemic heart disease (IHD) and heart failure (HF) without OA, (iii) index OA without CVD and (iv) same CVD groups with comorbid OA. The measure of CP physical limitations was Seattle Angina Questionnaire and for SOB physical limitations was the Kansas City Cardiomyopathy Questionnaire. Adjusted baseline associations between the cohorts and symptom-specific physical limitations were assessed using linear regression methods. In the study population, 1443 (27%) reported CP and 2097 (39%) SOB. CP and SOB physical limitations increased with CVD severity in the index and comorbid groups. Compared with the respective index CVD group, the CP physical limitation scores for comorbid CVD groups with OA were lower by: -14.7 (95% CI -21.5, 7.8) for hypertension, -5.5 (-10.4, -0.7) for IHD and -22.1 (-31.0, -6.7) for HF. For SOB physical limitations, comorbid scores were lower by: -9.2 (-13.8, -4.6) for hypertension, -6.4 (-11.1, -1.8) for IHD and -8.8 (-19.3, 1.65) for HF.
Conclusions:
CP and SOB are common symptoms, and OA increases the CVD symptom-specific physical limitations additively. Comorbidity interventions need to be developed for CVD specific health outcomes.
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