European Journal of Epidemiology

, Volume 25, Issue 4, pp 253–260 | Cite as

Chronic obstructive pulmonary disease and the risk of cardiovascular diseases

  • Cornelia Schneider
  • Ulrich Bothner
  • Susan S. Jick
  • Christoph R. Meier


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.


Arrhythmia Chronic obstructive pulmonary disease Deep vein thrombosis Myocardial infarction Pulmonary embolism Stroke 



Angiotensin converting enzyme


Body mass index


Confidence interval


Chronic obstructive pulmonary disease


C-reactive protein


Deep vein thrombosis


Forced expiratory volume in 1 s


General practitioner


General Practice Research Database


Incidence rate


Independent Scientific Advisory Committee


Medicines and Healthcare products Regulatory Agency


Myocardial infarction


Odds ratio


Pulmonary embolism


Person years


Transient ischemic attack



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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Copyright information

© Springer Science+Business Media B.V. 2010

Authors and Affiliations

  • Cornelia Schneider
    • 1
  • Ulrich Bothner
    • 2
  • Susan S. Jick
    • 3
  • Christoph R. Meier
    • 1
    • 3
    • 4
  1. 1.Basel Pharmacoepidemiology Unit, Division of Clinical Pharmacy and Epidemiology, Department of Pharmaceutical SciencesUniversity of BaselBaselSwitzerland
  2. 2.Nycomed GmbHConstanceGermany
  3. 3.Boston Collaborative Drug Surveillance ProgramBoston University School of MedicineLexingtonUSA
  4. 4.Hospital PharmacyUniversity Hospital BaselBaselSwitzerland

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