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Bronchiectasis and the risk of cardiovascular disease: a population-based study

Vidya Navaratnam^1,2,3, Elizabeth R C Millett², John R Hurst⁴

¹Division of Epidemiology and Public Health, University of Nottingham, Nottingham, UK.

|August 31, 2016

Insights

People with bronchiectasis have a higher risk of developing coronary heart disease (CHD) and stroke. This study highlights the increased cardiovascular burden in bronchiectasis patients, necessitating integrated care approaches.

Area of Science:

Pulmonary Medicine
Cardiovascular Medicine
Epidemiology

Background:

Limited data exist on cardiovascular comorbidities in individuals with bronchiectasis.
Bronchiectasis is a chronic lung condition with potential systemic implications.
Cardiovascular diseases, including coronary heart disease (CHD) and stroke, are significant health concerns.

Purpose of the Study:

To estimate the prevalence of pre-existing coronary heart disease (CHD) and stroke in people with bronchiectasis.
To investigate the risk of incident CHD and stroke events in individuals with bronchiectasis compared to the general population.

Main Methods:

Utilized primary care electronic health records from the Clinical Practice Research Datalink.
Employed logistic regression for cross-sectional analysis of pre-existing diagnoses.
Used Cox regression to assess incident CHD and stroke risk, adjusting for key demographic and clinical factors.

Main Results:

Individuals with bronchiectasis showed higher odds of pre-existing CHD (OR 1.33) and stroke (OR 1.92).
The incidence rates of first CHD (HR 1.44) and stroke (HR 1.71) were significantly elevated in the bronchiectasis cohort.
Adjustments were made for age, sex, smoking status, and other cardiovascular risk factors.

Conclusions:

People with bronchiectasis face a demonstrably higher risk of CHD and stroke.
Increased clinical awareness of these cardiovascular comorbidities is crucial for comprehensive patient management.
An integrated care model is recommended for patients with bronchiectasis and co-existing cardiovascular conditions.

Read full analysis

Abstract

Background:

There are limited data on the burden of cardiovascular comorbidities in people with bronchiectasis. Our cross-sectional study estimates the burden of pre-existing diagnoses of coronary heart disease (CHD) and stroke in people with bronchiectasis compared with the general population. The historical cohort study investigates if individuals with bronchiectasis are at increased risk of incident CHD and stroke events.

Methods:

We used primary care electronic records from the Clinical Practice Research Datalink. The cross-sectional study used logistic regression to quantify the association between bronchiectasis and recorded diagnoses of CHD or stroke. Cox regression was used to investigate if people with bronchiectasis experienced increased incident CHD and strokes compared with the general population, adjusting for age, sex, smoking habit and other risk factors for cardiovascular disease.

Results:

Pre-existing diagnoses of CHD (OR 1.33, 95% CI 1.25 to 1.41) and stroke (OR 1.92, 95% CI 1.85 to 2.01) were higher in people with bronchiectasis compared with those without bronchiectasis, after adjusting for age, sex, smoking and risk factors for cardiovascular disease. The rate of first CHD and stroke were also higher in people with bronchiectasis (HR for CHD 1.44 (95% CI 1.27 to 1.63) and HR for stroke 1.71 (95% CI 1.54 to 1.90)).

Conclusion:

The risk of CHD and stroke are higher among people with bronchiectasis compared with the general population. An increased awareness of these cardiovascular comorbidities in this population is needed to provide a more integrated approach to the care of these patients.

Keywords:

Bronchiectasis Clinical Epidemiology

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