Cardiovascular diseases common, more likely among adults with COPD

Key takeaways:

• More adults with vs. without COPD suffered with at least one cardiovascular disease.
• The likelihood for having one or more cardiovascular disease was higher among those with COPD.

Cardiovascular disease appeared more frequently in adults with vs. without COPD, and they faced increased odds for having one or more of these diseases, according to data published in BMC Pulmonary Medicine.

“Patients with COPD have a higher prevalence of one or more [cardiovascular diseases] (including coronary heart disease, heart failure, heart attack and diabetes) compared with those without COPD,” Hong Chen, MD, of the department of respiratory and critical care medicine at Chengdu Second People’s Hospital, and colleagues wrote. “Our findings highlight the importance of cardiovascular disease (CVD) prevention and management in patients with COPD.”

In a population-based cross-sectional study, Chen and colleagues used National Health and Nutrition Examination Survey (NHANES) results from 2013 to 2018 to evaluate 11,425 American adults aged 40 years and older and determine if COPD is related to a higher prevalence of CVD, which includes coronary heart disease, heart failure, angina pectoris, heart attack, diabetes and stroke.

Of the total cohort, 661 adults (mean age, 64.3 years; 47.6% men; 80.5% non-Hispanic white) had COPD, and the remaining 10,764 adults (mean age, 58.1 years; 47.2% men; 68% non-Hispanic white) did not have COPD.

Notably, less adults with vs. without COPD reported current smoking (46.4% vs. 66.2%).

Between the two groups, adults with COPD also had higher blood eosinophil counts (≥ 300 cells/µL, 33.2% vs. 25.2%), a greater prevalence of belonging to the lowest annual family income category (< $35,000, 58.3% vs. 28%) and a lower percentage of adults who achieved more than a high school education (44.5% vs. 63.7%).

Nearly 60% of patients with COPD had one CVD, whereas only 28.4% of adults without COPD had one CVD. According to researchers, more adults with COPD also had at least two CVDs (32.8% vs. 8.3%) and three or more CVDs (19.4% vs. 3.5%).

Researchers found that patients with vs. without COPD faced higher odds for having a CVD, which increased with each rise in prevalence (one CVD, adjusted OR = 2.2; 95% CI, 1.6-3; ≥ 2 CVDs, aOR = 3.3; 95% CI, 2.2-5; ≥ 3 CVDs, aOR = 4.3; 95% CI, 2.9-6.5) in a multivariable logistic regression model adjusted for baseline demographics, lifestyle factors, inflammation indicators and comorbidities related to COPD.

When broken down by specific CVD, researchers observed significant increased odds among patients with COPD for a higher prevalence of coronary heart disease (aOR = 4; 95% CI, 2.7-5.9), heart failure (aOR = 5.6; 95% CI, 3.2-9.7), heart attack (aOR = 3.2; 95% CI, 2-5) and diabetes (aOR = 1.8; 95% CI, 1.3-2.5) compared with adults without COPD.

“Further prospective studies are needed to confirm the association between COPD and CVD and whether there is causality between the two,” Chen and colleagues wrote. “[Additionally], it should be noted that participants in the NHANES study were predominantly non-Hispanic white and non-Hispanic Black individuals from the United States, and thus generalization of our findings to other populations should be approached with caution.”