Cardiovascular diseases (CVDs) are prevalent in 59.6% of those with chronic obstructive pulmonary disease (COPD) and are twice as prevalent in those with vs without COPD, according to study findings published in BMC Pulmonary Medicine.
CVD is the most commonly noted comorbidity in patients with COPD and the association increases with age; however, the difference in the prevalence of CVDs in those with vs without COPD has been unexplored. Investigators therefore sought to explore the association between COPD and the prevalence of CVDs in adults at least 40 years of age in the US. For study purposes, cardiovascular diseases were defined as coronary heart disease, heart failure, angina, heart attack, diabetes, and stroke.
The researchers conducted a population-based cross-sectional study comparing the prevalence of CVDs in those with and without COPD using data from the US National Health and Nutrition Examination Survey (NHANES) collected between 2013 and 2018. During this time period, the NHANES collected information from more than 29,000 adults and children in the US on their nutritional and health status.
The current analysis included data from 11,425 NHANES participants who were at least 40 years of age (661 with COPD and 10,764 without). Individuals with COPD vs those without (ie, the control group) were more likely to be non-Hispanic White (80.5% vs 68.0%) and to be aged 65 years or older (45.5% vs 30.2%), were less likely to smoke (46.4% vs 66.2%) and more likely to never have smoked (53.6% vs 33.8%), were more likely to have a blood eosinophil count of at least 300/µL (33.2% vs 25.2%), were less likely to have education beyond the high school level (44.5% vs 63.7%), and had a lower annual family income.
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Our findings highlight the importance of CVD prevention and management in patients with COPD.
The investigators noted patients with COPD vs those without had a significantly greater prevalence of CVD (59.6% vs 28.4%). COPD was significantly associated with the prevalence of 1 CVD (odds ratio [OR], 2.2; 95% CI, 1.6-3.0); 2 or more CVDs (OR, 3.3; 95% CI, 2.2-5.0); and 3 or more CVDs (OR, 4.3; 95% CI, 2.9-6.5) (all P <.001).
The prevalence of specific CVDs in those with and without COPD was as follows: coronary heart disease, 24% vs 5%; heart failure, 19% vs 3%; heart attack, 22% vs 4%; diabetes, 30% vs 15%. A significant association between COPD and these 4 CVDs was seen in all multivariable logistic regression models (accounting for demographic characteristics, lifestyle, inflammation indicators, and comorbidities associated with COPD).
Study limitations include the lack of causality from a cross-sectional study, unaccounted-for severity of COPD, and self-report bias in NHANES survey answers.
“Patients with COPD have a higher prevalence of one or more CVDs compared with those without COPD,” the investigators concluded. The study authors wrote, “Our findings highlight the importance of CVD prevention and management in patients with COPD.”
