Chest
Original ResearchCOPDHigh Prevalence of Undiagnosed Airflow Limitation in Patients With Cardiovascular Disease
Section snippets
Design of the Study
Figure 1 shows the flowchart of participants. Participants in the follow-up of an ongoing population-based study, the COR Sà Illes Balears (CORSAIB), aimed at investigating the distribution of CVD and CVD risk factors in the general population of the Balearic Islands, Spain, were invited to participate also in our study. The design and full methodological details of the CORSAIB study have been published elsewhere.10 Briefly, it started in 1999 and randomly selected a representative sample,
Sampling
As per Figure 1, we studied 1,113 participants from the original CORSAIB cohort plus a sample of 165 hospital patients with CAD, and spirometry was obtained in 1,002 and all 165, respectively. However, spirometry current quality control standards were only fulfilled by 509 (51%) and 120 (73%), respectively. A nonresponse study was conducted, comparing sociodemographic and clinical variables between the participants whose spirometry did/did not pass spirometry quality control (Table 1). Given
Discussion
COPD is now considered a novel CV risk factor because the burden of CV disease is higher in smokers with COPD than in those without it.6 Yet, the prevalence, level of diagnosis, and adequacy of treatment of COPD among patients with CVD has not been investigated before, to our knowledge. Our results show that one of every three patients with CAD recruited from the hospital clinic, and one of every five patients with CVD in the general population, suffer AL compatible with COPD, that the majority
Conclusions
Our results show that the prevalence of AL in patients with CVD is substantial (one in three CAD patients seen in hospital clinics, and about one in five patients with CVD in the general population), that most of these patients are not diagnosed appropriately (60% in CVD patients from the community and up to 87% in patients with CAD in the hospital), and that the majority of them are not treated whatsoever (60% in all groups). Given that COPD is a preventable and treatable disease,15, 16 this
Acknowledgments
Author contributions: Dr Soriano: contributed to the design and protocol of the study, obtaining funding, developing the plan of analysis, drafting the report, performing statistical analysis, and writing and approving the manuscript.
Dr Rigo: contributed to the design and protocol of the study, obtaining funding, and writing and approving the manuscript.
Ms Guerrero: contributed to statistical analysis and to writing and approving the manuscript.
Dr Yañez: contributed to writing and approving the
References (26)
- et al.
Alternative projections of mortality and disability by cause 1990-2020: Global Burden of Disease Study
Lancet
(1997) - et al.
International variation in the prevalence of COPD (the BOLD Study): a population-based prevalence study
Lancet
(2007) - et al.
Patterns of comorbidities in newly diagnosed COPD and asthma in primary care
Chest
(2005) - et al.
A new method of classifying prognostic comorbidity in longitudinal studies: development and validation
J Chronic Dis
(1987) - et al.
Cardiovascular disease in patients with chronic obstructive pulmonary disease, Saskatchewan Canada cardiovascular disease in COPD patients
Ann Epidemiol
(2006) - et al.
Chronic obstructive pulmonary disease in five Latin American cities (the PLATINO study): a prevalence study
Lancet
(2005) - et al.
Screening for and early detection of COPD: feasibility and impact
Lancet
(2009) Striving to deconfound the fundamentals of epidemiologic study design
J Clin Epidemiol
(1988)- et al.
Chronic obstructive pulmonary disease: current burden and future projections
Eur Respir J
(2006) - et al.
Global burden of COPD: systematic review and meta-analysis
Eur Respir J
(2006)
The global burden of chronic diseases: overcoming impediments to prevention and control
JAMA
Chronic obstructive pulmonary disease as a risk factor for cardiovascular morbidity and mortality
Proc Am Thorac Soc
Medical event profiling of COPD patients
Pharmacoepidemiol Drug Saf
Cited by (80)
Multidisciplinary Management of Patients With Chronic Obstructive Pulmonary Disease and Cardiovascular Disease
2024, Archivos de BronconeumologiaCOPD prevalence in smokers with stable ischemic heart disease: A cross-sectional study in Tunisia
2021, Respiratory MedicineCitation Excerpt :The group with COPD had a higher burden of heart disease and symptoms. The prevalence of COPD in our study was 19.7%, which is close to that reported in previous studies, varying from 4% to 33.6% [17–25]. This prevalence is higher than that found in the general population in Tunisia (5.3%) [26].
Chronic obstructive pulmonary disease as a risk factor for ventricular arrhythmias independent of left ventricular function
2018, Heart RhythmCitation Excerpt :Further studies are needed to explore these phenomena. COPD and heart disease commonly coexist (COPD affects one-fourth of cardiac patients),27 and COPD is markedly underdiagnosed (in a staggering 60% to 87% of affected patients),27 likely because dyspnea is commonly attributed to heart disease alone. The strength of our study is that it focused on a sample of patients in whom lung function had been objectively quantified by PFT in order to minimize classification error.
Lower limit of normal vs. fixed ratio for the diagnosis of COPD: Is it that important?
2018, Revue des Maladies RespiratoiresEvaluation for airway obstruction in adult patients with stable ischemic heart disease
2018, Indian Heart Journal
Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (www.chestjournal.org/site/misc/reprints.xhtml).
Funding/Support: This study was supported by research grants [FIS PI061228 for 2007-2009], redIAPP Grupo cardiovascular de Baleares [RD06/0018/0045] from the Instituto de Salud Carlos III, and by a generous donation from Fundación Barceló (www.fundacionbarcelo.org).
- 1
Dr Agustí is currently at the Institut Clínic del Tòrax, Hospital Clínic, Universitat de Barcelona (Barcelona, Spain).