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Chronic obstructive pulmonary disease and the risk of cardiovascular diseases

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Abstract

Previous large epidemiological studies reporting on the association between chronic obstructive pulmonary disease (COPD) and cardiovascular diseases mainly focussed on prevalent diseases rather than on the incidence of newly diagnosed cardiovascular outcomes. We used the UK-based General Practice Research Database (GPRD) to assess the prevalence and incidence of cardiovascular diseases in COPD patients aged 40–79 between 1995 and 2005, and we randomly matched COPD-free comparison patients to COPD patients. In nested-case control analyses, we compared the risks of developing an incident diagnosis of cardiac arrhythmias, venous thromboembolism, myocardial infarction, or stroke between patients with and without COPD, stratifying the analyses by COPD-severity, using COPD-treatment as proxy for disease severity. We identified 35,772 patients with COPD and the same number of COPD-free patients. Most cardiovascular diseases were more prevalent among COPD patients than among the comparison group of COPD-free patients. The relative risk estimates of developing an incident diagnosis of cardiac arrhythmia (OR 1.19, 95% CI 0.98–1.43), deep vein thrombosis (OR 1.35, 95% CI 0.97–1.89), pulmonary embolism (OR 2.51, 95% CI 1.62–3.87), myocardial infarction (OR 1.40, 95% CI 1.13–1.73), or stroke (OR 1.13, 95% CI 0.92–1.38), tended to be increased for patients with COPD as compared to COPD-free controls. The findings of this large observational study provide further evidence that patients with COPD are at increased risk for most cardiovascular diseases.

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Abbreviations

ACE:

Angiotensin converting enzyme

BMI:

Body mass index

CI:

Confidence interval

COPD:

Chronic obstructive pulmonary disease

CRP:

C-reactive protein

DVT:

Deep vein thrombosis

FEV1 :

Forced expiratory volume in 1 s

GP:

General practitioner

GPRD:

General Practice Research Database

IR:

Incidence rate

ISAC:

Independent Scientific Advisory Committee

MHRA:

Medicines and Healthcare products Regulatory Agency

MI:

Myocardial infarction

OR:

Odds ratio

PE:

Pulmonary embolism

Py:

Person years

TIA:

Transient ischemic attack

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Acknowledgments

Source of funding: This study was funded by an unconditional grant by Nycomed GmbH. Financial Disclosure: Dr. Ulrich Bothner was employed by Nycomed GmbH at that time.

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Correspondence to Christoph R. Meier.

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Schneider, C., Bothner, U., Jick, S.S. et al. Chronic obstructive pulmonary disease and the risk of cardiovascular diseases. Eur J Epidemiol 25, 253–260 (2010). https://doi.org/10.1007/s10654-010-9435-7

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  • DOI: https://doi.org/10.1007/s10654-010-9435-7

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