Cardiac autonomic neuropathy: The hidden cardiovascular comorbidity in elderly patients with chronic obstructive pulmonary disease attending primary care settings
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1Geriatric Medicine and Gerontology, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
Insights
Elderly patients with chronic obstructive pulmonary disease (COPD) frequently experience comorbidities. Cardiac autonomic neuropathy (CAN) is prevalent in these patients and linked to hypercapnia.
Area of Science:
- Geriatric Medicine
- Pulmonology
- Cardiology
Background:
- Chronic obstructive pulmonary disease (COPD) is a progressive lung disease often accompanied by various chronic comorbidities.
- Cardiac autonomic neuropathy (CAN) is a potential complication affecting cardiovascular regulation in patients with chronic diseases.
Purpose of the Study:
- To determine the prevalence of chronic comorbidities, specifically cardiac autonomic neuropathy (CAN), in elderly male patients diagnosed with COPD.
Main Methods:
- A cross-sectional study involving 175 elderly male COPD patients at Ain Shams University Hospital, Cairo, Egypt.
- Assessment included identifying comorbidities, pulmonary function tests, arterial blood gas analysis, and cardiovascular reflex testing for autonomic function.
Main Results:
- A significant majority (69.14%) of COPD patients had comorbidities, with hypertension (34.20%) and cor pulmonale (31.42%) being most common.
- Among patients without other reported comorbidities, 29.60% showed early CAN and 22.20% had definite CAN.
- CAN was associated with hypercapnia but not with hypoxemia or COPD severity, and it was observed even in mild COPD cases.
Conclusions:
- Elderly male COPD patients exhibit a wide range of comorbidities, including a notable prevalence of cardiac autonomic neuropathy.
- Cardiac autonomic neuropathy in this population is linked to hypercapnia, highlighting the complex interplay between respiratory and cardiovascular health.
Aim:
To quantify the prevalence of chronic comorbidities including cardiac autonomic neuropathy among elderly patients with chronic obstructive pulmonary disease (COPD).
Methods:
A cross-sectional study was carried out on 175 elderly male patients with COPD attending Ain Shams University Hospital, Cairo, Egypt. The comorbidities that might alter cardiac autonomic function in patients with COPD were identified. The patients without reported comorbidities underwent arterial blood gas analysis, pulmonary function tests and autonomic function assessment using cardiovascular reflexes.
Results:
A total of 69.14% of the participants presented with comorbidities (group 1), whereas 30.85% of the participants reported no comorbidity (group 2). Among the participants, the most prevalent comorbid diseases were hypertension (34.20%), cor pulmonale (31.42%), ischemic heart disease (20.00%), diabetes (18.28%) and congestive heart failure (13.70%). In group 2, 29.60% and 22.20% of the patients had early and definite cardiac autonomic neuropathy (CAN) respectively. CAN occurred early in the course of the disease with 40.90% of mild COPD cases being affected. The patients with definite CAN had the highest resting heart rate. The presence of CAN was related to hypercapnia, but not hypoxemia or COPD severity.
Conclusion:
COPD has a complex spectrum of comorbidities. Cardiac autonomic neuropathy in elderly male patients with COPD correlated with hypercapnia, but not hypoxemia or the disease severity.
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