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
RESPIRATORY DISEASES

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

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

Notes

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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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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