Burden of cardiovascular disease in chronic obstructive pulmonary disease

Abstract

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.