Chronic obstructive pulmonary disease and the risk of cardiovascular diseases Authors
First Online: 27 February 2010 Received: 20 March 2009 Accepted: 05 February 2010 DOI:
Cite this article as: Schneider, C., Bothner, U., Jick, S.S. et al. Eur J Epidemiol (2010) 25: 253. doi:10.1007/s10654-010-9435-7 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.
Keywords Arrhythmia Chronic obstructive pulmonary disease Deep vein thrombosis Myocardial infarction Pulmonary embolism Stroke Abbreviations ACE
Angiotensin converting enzyme
Body mass index
Chronic obstructive pulmonary disease
Deep vein thrombosis
Forced expiratory volume in 1 s
General Practice Research Database
Independent Scientific Advisory Committee
Medicines and Healthcare products Regulatory Agency
Transient ischemic attack
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