Cardiovascular diseases (CVDs) and chronic obstructive pulmonary disease (COPD) have similar prevalence rates and risk factors, and both frequently occur in the same patient. The primary objective of the study was to evaluate the rate of COPD patients among subjects with some form of CVD referring to a smoking cessation unit. The secondary objective was to analyze the demographic and clinical profile of these subjects and to identify independent factors potentially associated with COPD.
Observational, prospective study involving 132 patients with smoking habits, and some form of CVD, referring to the smoking cessation unit at the Pulmonology Department of the University Hospital of Cáceres, Spain, between October 2015 and March 2017.
A total of 58 patients (43.9%) were diagnosed with COPD. Main CVDs were: ischemic heart disease (76.5%), chronic heart failure (24.8%), peripheral arterial disease (18.5%), and atrial fibrillation (7.6%). Independent factors were: pack-years (> 30 versus < 30; odds ratio, OR 5.3; 95% CI 1.3–21.4); forced expiratory volume in the first second (OR 0.9; 95% CI 0.9–1.0); chronic heart failure (yes versus no; OR 4.7; 95% CI 1.3–16.4); and modified Medical Research Council (mMRC) dyspnea (2–3 versus 0; OR 18.7; 95% CI 1.9–182.0).
Four of ten patients with some form of CVD also experience COPD. Dyspnea, airflow limitation, smoking habits, and chronic heart failure were significant factors associated with COPD in patients with CVD. Smoking cessation units are useful to improve the diagnosis of COPD in these patients. Further prospective studies with a greater cohort of patients are required to corroborate the present results and to enhance the knowledge of the clinical profile of these patients.
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World Health Organization. COPD predicted to be third leading cause of death in 2030. https://www.who.int/respiratory/copd/World_Health_Statistics_2008/en/. Accessed 10 June 2019.
Blanco I, Diego I, Bueno P, et al. Geographical distribution of COPD prevalence in Europe, estimated by an inverse distance weighting interpolation technique. Int J Chronic Obstr Pulm Dis. 2017;13:57–67.
Lamprecht B, Soriano JB, Studnicka M, et al. Determinants of underdiagnosis of COPD in national and international surveys. Chest. 2015;148(4):971–85.
Ingebrigtsen TS, Marott JL, Vestbo J, et al. Characteristics of undertreatment in COPD in the general population. Chest. 2013;144(6):1811–8.
Vogelmeier CF, Criner GJ, Martínez FJ, et al. Global strategy for the diagnosis, management, and prevention of chronic obstructive lung disease 2017 report: GOLD executive summary. Arch Bronconeumol. 2017;53(3):128–49.
Wedzicha JA, Calverley PMA, Albert RK, et al. Prevention of COPD exacerbations: a European Respiratory Society/American Thoracic Society guideline. Eur Respir J. 2017;50(3):1602265.
Chen W, Thomas J, Sadatsafavi M, FitzGerald JM. Risk of cardiovascular comorbidity in patients with chronic obstructive pulmonary disease: a systematic review and meta-analysis. Lancet Respir Med. 2015;3(8):631–9.
Divo M, Cote C, de Torres JP, et al. Comorbidities and risk of mortality in patients with chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 2012;186(2):155–61.
Almirall J, Fortin M. The coexistence of terms to describe the presence of multiple concurrent diseases. J Comorbidity. 2013;3:4–9.
Barnett K, Mercer SW, Norbury M, Watt G, Wyke S, Guthrie B. Epidemiology of multimorbidity and implications for health care, research, and medical education: a cross-sectional study. Lancet. 2012;380(9836):37–433.
Divo MJ, Martinez CH, Mannino DM. Ageing and the epidemiology of multimorbidity. Eur Respir J. 2014;44(4):1055–68.
van Oostrom SH, Picavet HS, de Bruin SR, et al. Multimorbidity of chronic diseases and health care utilization in general practice. BMC Fam Pract. 2014;15:61.
Wong MC, Liu J, Zhou S, et al. The association between multimorbidity and poor adherence with cardiovascular medications. Int J Cardiol. 2014;177:477–82.
Marengoni A, Onder G. Guidelines, polypharmacy, and drug-drug interactions in patients with multimorbidity. BMJ. 2015;350:h1059.
Marengoni A, Angleman S, Melis R, et al. Aging with multimorbidity: a systematic review of the literature. Ageing Res Rev. 2011;10:430–9.
Nunes BP, Flores TR, Mielke GI, Thumé E, Facchini LA. Multimorbidity and mortality in older adults: a systematic review and meta-analysis. Arch Gerontol Geriatr. 2016;67:130–8.
McGarvey LP, John M, Anderson JA, Zvarich M, Wise RA. Ascertainment of cause-specific mortality in COPD: operations of the TORCH Clinical Endpoint Committee. Thorax. 2007;62(5):411–5.
Morgan AD, Zakeri R, Quint JK. Defining the relationship between COPD and CVD: what are the implications for clinical practice? Ther Adv Respir Dis. 2018;12:1753465817750524.
Roversi S, Fabbri LM, Sin DD, Hawkins NM, Agustí A. Chronic obstructive pulmonary disease and cardiac diseases. An urgent need for integrated care. Am J Respir Crit Care Med. 2016;194(11):1319–36.
Bestall JC, Paul EA, Garrod R, Garnham R, Jones PW, Wedzicha JA. Usefulness of the medical research council (MRC) dyspnoea scale as a measure of disability in patients with chronic obstructive pulmonary disease. Thorax. 1999;54(7):581–6.
Miravitllesa M, Soler-Cataluña JJ, Calle M, et al. Spanish guidelines for management of chronic obstructive pulmonary disease (GesEPOC) 2017. Pharmacological treatment of stable phase. Arch Bronconeumol. 2017;53(6):324–35.
Rabe KF, Hurst JR, Suissa S. Cardiovascular disease and COPD: dangerous liaisons? Eur Respir Rev. 2018;27(149):180057.
Montserrat-Capdevila J, Seminario MA, Godoy P, et al. Prevalence of chronic obstructive pulmonary disease (COPD) not diagnosed in a population with cardiovascular risk factors. Med Clin. 2018;151(10):383–9.
Anzueto A, Miravitlles M. Pathophysiology of dyspnea in COPD. Postgrad Med. 2017;129(3):366–74.
Mahler DA, Ward J, Waterman LA, et al. Patient-reported dyspnea in COPD reliability and association with stage of disease. Chest. 2009;136:1473–9.
Miravitlles M, de la Roza C, Morera J, et al. Chronic respiratory symptoms, spirometry and knowledge of COPD among general population. Respir Med. 2006;100(11):1973–80.
Engström G, Hedblad B, Janzon L, Valind S. Respiratory decline in smokers and ex-smokers-an independent risk factor for cardiovascular disease and death. J Cardiovasc Risk. 2000;7(4):267–72.
Franssen FM, Soriano JB, Roche N, et al. Lung function abnormalities in smokers with ischemic heart disease. Am J Respir Crit Care Med. 2016;194(5):568–76.
Agarwal SK, Heiss G, Barr RG, et al. Airflow obstruction, lung function, and risk of incident heart failure: the Atherosclerosis Risk in Communities (ARIC) study. Eur J Heart Fail. 2012;14(4):414–22.
We thank the participants of the study.
This study was funded by a “Fellowship, Non-Restriction” sponsorship from Laboratorios ROVI, S.A. The Rapid Service Fee was funded by Laboratorios ROVI, S.A.
All named authors meet the International Committee of Medical Journal Editors (ICMJE) criteria for authorship for this article, take responsibility for the integrity of the work as a whole, and have given their approval for this version to be published.
Juan Antonio Riesco Miranda participated in the conception and design of the study, review of the bibliography analysis, and interpretation of the study’s results. He also drafted and revised the document and agrees with the final version. María Hidalgo participated in data collection. She also drafted and revised the document and agrees with the final version. David Chipayo participated in data collection. He also drafted and revised the document and agrees with the final version. José Javier Gómez Barrado participated in the conception and design of the study. He also drafted and revised the document and agrees with the final version. Fernando Zaragozá participated in the work of scientific advisory expertise in the preparation of the document.
Juan A. Riesco, María Hidalgo, David Chipayo, José J. Gómez, and Fernando Zaragozá have nothing to disclose.
Compliance with Ethics Guidelines
All patients signed the written informed consent to participate in the study. Procedures were approved by the ethics committee of the University Hospital of Cáceres, in accordance with the Declaration of Helsinki.
The data stored from this study are on a database created for the study. They are not publicly available but are available from the corresponding author on reasonable request.
To view digital features for this article go to https://doi.org/10.6084/m9.figshare.12424469.
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Riesco, J.A., Hidalgo, M., Chipayo, D. et al. Profile of Cardiovascular Disease Patients Who are Diagnosed with COPD in a Smoking-Cessation Unit. Adv Ther (2020). https://doi.org/10.1007/s12325-020-01403-0
- Cardiovascular disease