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Burden of cardiovascular disease in chronic obstructive pulmonary disease
Shikhar Agarwal1, Haala Rokadia2, Todd Senn1
1Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio.
Insights
Individuals with chronic obstructive pulmonary disease (COPD) have a higher prevalence of cardiovascular and cerebrovascular disease (CCVD). COPD patients also face an increased risk of developing future CCVD compared to those without COPD.
Area of Science:
- Cardiology
- Pulmonology
- Epidemiology
Background:
- Chronic obstructive pulmonary disease (COPD) and atherosclerotic vascular disease share common etiopathogenic factors.
- Understanding the link between COPD and cardiovascular/cerebrovascular disease (CCVD) is crucial for patient management.
Purpose of the Study:
- To compare the prevalence of self-reported CCVD in COPD versus non-COPD individuals.
- To assess future CCVD risk in COPD and non-COPD subjects without pre-existing CCVD.
Main Methods:
- Analysis of pooled National Health and Nutrition Examination Survey (NHANES) data (2007-2010).
- Classification of subjects without CCVD based on predicted Framingham risk (short-term and lifetime).
Main Results:
- COPD patients had a significantly higher prevalence of self-reported CCVD (20.0%) compared to non-COPD subjects (7.4%).
- COPD was identified as an independent risk factor for prevalent CCVD.
- Subjects with COPD showed a higher predicted risk for future CCVD, particularly high short-term risk (35.8% vs 18.9%).
Conclusions:
- Self-reported CCVD prevalence is substantially higher in individuals with COPD.
- COPD is associated with an elevated risk of developing future cardiovascular and cerebrovascular diseases.
Background:
Chronic obstructive pulmonary disease (COPD) and atherosclerotic vascular disease share several etiopathogenic factors.
Purpose:
To compare the prevalence of self-reported cardiovascular and cerebrovascular disease (CCVD) between COPD and non-COPD subjects using the National Health and Nutrition Examination Survey (NHANES) database. Among subjects without pre-existent CCVD, the short-term and lifetime risks of future CCVD were also compared between the two groups.
Methods:
Pooled NHANES 2007-2010 data were analyzed in May 2012 and April 2013. Based on predicted Framingham risk, subjects without self-reported CCVD were classified as follows: high short-term risk, low short-term/high lifetime risk, and low short-term/low lifetime risk for future CCVD.
Results:
Estimated self-reported CCVD prevalence was 20.0% and 7.4% in COPD and non-COPD groups, respectively (p<0.001). On multivariable analysis, COPD was an independent risk factor for prevalent self-reported CCVD (prevalence ratio=1.4, 95% CI=1.1, 1.8). Among subjects without CCVD, there were significant differences in predicted future CCVD risk between the two groups. In the non-COPD group, prevalence of high short-term risk, low short-term/high lifetime risk, and low short-term/low lifetime risk was 18.9%, 62.7%, and 18.4%, respectively. In the COPD group, corresponding prevalence estimates were 35.8%, 53.2%, and 11.1%, respectively. Men and women had significantly different risk factor profiles for future CCVD.
Conclusions:
The prevalence of self-reported CCVD was significantly higher in subjects with COPD than in those without COPD. Among subjects without pre-existent CCVD, the risk of future CCVD was significantly higher in the COPD group than in the non-COPD group.
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