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Role of COPD in Evaluation of Cardiovascular Risk

  • NOVEL AND EMERGING RISK FACTORS (N WONG AND C LEWIS, SECTION EDITORS)
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Abstract

The association between chronic obstructive pulmonary disease (COPD) and cardiovascular disease (CVD) has been documented through a substantial number of studies within the past few decades. This review examines the historical development of pulmonary function as a risk factor for CVD and elucidates on the possible mechanisms of this association prescribed by the contemporary literature. Most data indicates pulmonary inflammation as a substantial factor in the initiation of CVD, but the precise mechanism remains ambiguous. Additionally, COPD often remains misdiagnosed or underdiagnosed due to the lack of apparent symptoms and an adequate classification scheme, exacerbating the high costs of managing this illness. Furthermore, there are no well proven methods for the prevention of COPD outside of smoking cessation. The current literature reveals a discrepancy in the assessment of COPD as a predictor of CVD and highlights a need for future studies.

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References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. World Health Organization. Chronic obstructive pulmonary disease (COPD) fact sheet. World Health Organization website. www.who.int/mediacentre/factsheets/fs315/en/index.html. Published November 2012. Accessed December 19, 2012.

  2. Mannino D et al. MMWR Morb Mortal Wkly Rep. 2002;51(SS-6):1–16.

    Google Scholar 

  3. Roger VL, Go AS, Lloyd-Jones DM, et al. Heart Disease and Stroke Statistics—2012 update a report from the American Heart Association. Circulation. 2012;125(1):e2–e220.

    Article  PubMed  Google Scholar 

  4. Kochanek KD, Xu JQ, Murphy SL, et al. Deaths: final data for 2009. Natl Vital Stat Rep. 2011;60(3).

  5. Holguin F, Folch E, Redd SC, Mannino DM. Comorbidity and mortality in COPD-related hospitalizations in the United States, 1979 to 2001. Chest. 2005;128(4):2005–11.

    Article  PubMed  Google Scholar 

  6. Pope 3rd CA, Burnett RT, Thurston GD, et al. Cardiovascular mortality and long-term exposure to particulate air pollution: epidemiological evidence of general pathophysiological pathways of disease. Circulation. 2004;109(1):71–7.

    Article  PubMed  Google Scholar 

  7. Stone IS, Barnes NC, Petersen SE. Chronic obstructive pulmonary disease: a modifiable risk factor for cardiovascular disease? Heart. 2012;98(14):1055–62.

    Article  PubMed  Google Scholar 

  8. Curkendall SM, DeLuise C, Jones JK, et al. Cardiovascular disease in patients with chronic obstructive pulmonary disease, Saskatchewan Canada. Ann Epidemiol. 2006;16(1):63–70.

    Article  PubMed  Google Scholar 

  9. Lusuardi M, Garuti G, Massobrio M, et al. Heart and lungs in COPD. Close friends in real life—separate in daily medical practice? Monaldi Arch Chest Dis. 2008;69(1):11–7.

    PubMed  CAS  Google Scholar 

  10. Kannel WB, D’Agostino RB, Silbershatz H. Use of vital capacity for cardiac failure risk estimation in persons with coronary disease and left ventricular hypertrophy. Am J Cardiol. 1996;77(14):1155–8.

    Article  PubMed  CAS  Google Scholar 

  11. Dalal AA, Shah M, Lunacsek O, Hanania NA. Clinical and economic burden of patients diagnosed with COPD with comorbid cardiovascular disease. Respir Med. 2011;105(10):1516–22.

    Article  PubMed  Google Scholar 

  12. Kannel WB, Hubert H, Lew EA. Vital capacity as a predictor of cardiovascular disease: the Framingham study. Am Heart J. 1983;105(2):311–5.

    Article  PubMed  CAS  Google Scholar 

  13. Cox CS, Mussolino ME, Rothwell ST, et al. Plan and operation of the NHANES I Epidemiologic Followup Study, 1992. Vital Health Stat 1. 1997;(35):1–231.

  14. Sin DD, Wu L, Man SFP. The relationship between reduced lung function and cardiovascular mortality*a population-based study and a systematic review of the literature. Chest. 2005;127(6):1952–9.

    Article  PubMed  Google Scholar 

  15. Soriano JB, Rigo F, Guerrero D, et al. High prevalence of undiagnosed airflow limitation in patients with cardiovascular disease. Chest. 2010;137(2):333–40.

    Article  PubMed  Google Scholar 

  16. Bérard E, Bongard V, Roche N, et al. Undiagnosed airflow limitation in patients at cardiovascular risk. Arch Cardiovasc Dis. 2011;104(12):619–26.

    Article  PubMed  Google Scholar 

  17. Hole DJ, Watt GC, Davey-Smith G, et al. Impaired lung function and mortality risk in men and women: findings from the Renfrew and Paisley prospective population study. BMJ. 1996;313(7059):711–5. discussion 715–716.

    Article  PubMed  CAS  Google Scholar 

  18. Lee HM, Le H, Lee BT, et al. Forced vital capacity paired with Framingham Risk Score for prediction of all-cause mortality. Eur Respir J. 2010;36(5):1002–6.

    Article  PubMed  CAS  Google Scholar 

  19. • Frantz S, Nihlén U, Dencker M, et al. Atherosclerotic plaques in the internal carotid artery and associations with lung function assessed by different methods. Clin Physiol Funct Imaging. 2012;32(2):120–5. This study uses novel lung function parameters in assessing the prevalence of CVD.

    Article  PubMed  CAS  Google Scholar 

  20. Marcus EB, Curb JD, MacLean CJ, et al. Pulmonary function as a predictor of coronary heart disease. Am J Epidemiol. 1989;129(1):97–104.

    PubMed  CAS  Google Scholar 

  21. • Cazzola M, Calzetta L, Bettoncelli G, et al. Cardiovascular disease in asthma and COPD: a population-based retrospective cross-sectional study. Respir Med. 2012;106(2):249–56. This large retrospective cross-sectional study provided evidence of the diagnosis of COPD in relation to CVD diagnosis and provided insight into its potential causes.

    Article  PubMed  Google Scholar 

  22. Lee HM, Truong ST, Wong ND. Evidence of lung function for stratification of cardiovascular disease risk. Korean Circ J. 2011;41(4):171–4.

    Article  PubMed  Google Scholar 

  23. Mannino DM, Ford ES, Redd SC. Obstructive and restrictive lung disease and markers of inflammation: data from the third national health and nutrition examination. Am J Med. 2003;114(9):758–62.

    Article  PubMed  Google Scholar 

  24. • Ford ES, Wheaton AG, Mannino DM, et al. Elevated cardiovascular risk among adults with obstructive and restrictive airway functioning in the United States: a cross-sectional study of the National Health and Nutrition Examination Survey from 2007–2010. Respir Res. 2012;13(1):115. This cross-sectional study used recent NHANES data from 2007 to 2010 to assess the causal relationship between COPD and CVD.

    Article  PubMed  Google Scholar 

  25. • Van Eeden S, Leipsic J, Paul Man SF, Sin DD. The relationship between lung inflammation and cardiovascular disease. Am J Respir Crit Care Med. 2012;186(1):11–6. This study reviews possible mechanistic pathways for which inflammation of the lungs can lead to acute cardiovascular symptoms.

    Article  PubMed  Google Scholar 

  26. D’Agostino Sr RB, Vasan RS, Pencina MJ, et al. General cardiovascular risk profile for use in primary care: the Framingham Heart Study. Circulation. 2008;117(6):743–53.

    Article  PubMed  Google Scholar 

  27. Lloyd-Jones DM, Wilson PWF, Larson MG, et al. Framingham risk score and prediction of lifetime risk for coronary heart disease. Am J Cardiol. 2004;94(1):20–4.

    Article  PubMed  Google Scholar 

  28. •• Lee HM, Lee J, Lee K, et al. Relation between COPD severity and global cardiovascular risk in US adults. Chest. 2012;142(5):1118–25. This study reveals a novel method of improving risk stratification of COPD patients for CVD using global CVD risk scores to predict the long term survival of COPD patients. The study has profound implications for improving the current clinical assessment tools of patients with COPD.

    Article  PubMed  CAS  Google Scholar 

  29. Celli BR, Cote CG, Marin JM, et al. The body-mass index, airflow obstruction, dyspnea, and exercise capacity index in chronic obstructive pulmonary disease. N Engl J Med. 2004;350(10):1005–12.

    Article  PubMed  CAS  Google Scholar 

  30. Cote CG, Pinto-Plata VM, Marin JM, et al. The modified BODE index: validation with mortality in COPD. Eur Respir J. 2008;32(5):1269–74.

    Article  PubMed  CAS  Google Scholar 

  31. Sin DD, Anthonisen NR, Soriano JB, Agusti AG. Mortality in COPD: role of comorbidities. Eur Respir J. 2006;28(6):1245–57.

    Article  PubMed  CAS  Google Scholar 

  32. Søyseth V, Brekke PH, Smith P, Omland T. Statin use is associated with reduced mortality in COPD. Eur Respir J. 2007;29(2):279–83.

    Article  PubMed  Google Scholar 

  33. Whittemore AS, Perlin SA, DiCiccio Y. Chronic obstructive pulmonary disease in lifelong nonsmokers: results from NHANES. Am J Public Health. 1995;85(5):702–6.

    Article  PubMed  CAS  Google Scholar 

  34. Young RP, Hopkins R, Eaton TE. Potential benefits of statins on morbidity and mortality in chronic obstructive pulmonary disease: a review of the evidence. Postgrad Med J. 2009;85(1006):414–21.

    Article  PubMed  CAS  Google Scholar 

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Conflict of Interest

Michael A. Liu declares that he has no conflict of interest.

Hwa Mu Lee declares that he has no conflict of interest.

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Authors and Affiliations

  1. Heart Disease Prevention Program, Division of Cardiology, Department of Medicine, University of California, 112 Sprague Hall, Irvine, CA, 92697-4101, USA

    Michael A. Liu

  2. Heart Disease Prevention Program, Division of Cardiology and Pulmonary Medicine, Department of Medicine, University of California, 112 Sprague Hall, Irvine, CA, 92697-4101, USA

    Hwa Mu Lee

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  1. Michael A. Liu
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Correspondence to Michael A. Liu.

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Liu, M.A., Lee, H.M. Role of COPD in Evaluation of Cardiovascular Risk. Curr Cardiovasc Risk Rep 7, 113–116 (2013). https://doi.org/10.1007/s12170-013-0292-2

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  • DOI: https://doi.org/10.1007/s12170-013-0292-2

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