Cardiovascular Comorbidity in Chronic Obstructive Pulmonary Disease: Systematic Literature Review.
Chest. 2013 May 30;
Authors: Müllerova H, Agusti A, Erqou S, Mapel DW
ABSTRACT BACKGROUND: Cardiovascular disease (CVD) is common among patients with chronic obstructive pulmonary disease (COPD). However, it is not clear whether this is due to shared risk factors or if COPD increases the risk for CVD independently. This study aimed to provide a systematic review of studies that investigated the association between COPD and CVD outcomes, assessing any effect of confounding by common risk factors. METHODS: A search was conducted in Medline (via PubMed) for observational studies published between January-1990 and March-2012 reporting cardiovascular comorbidity in COPD patients (or vice versa). RESULTS: Of the 7322 citations identified, 25 studies were found relevant for this systematic review. Twenty-two studies provided an estimate for CVD risk in COPD, whereas four studies provided estimates of COPD risk in CVD. The crude prevalence rate for aggregate CVD category ranged from 28% to 70%, likely due to differences in populations studied and CVD definitions; unadjusted relative risk (RR) estimates of unspecified CVD among patients with COPD compared to patients without COPD ranged from 2.1 to 5.0. The association between COPD and CVD persisted after adjustment for shared risk factors in the majority of the studies. Two studies found a relationship between the severity of airflow limitation and CVD risk. Increased RRs were observed for individual CVD types, but their estimates varied considerably for congestive heart failure, coronary heart disease, arrhythmias, stroke, arterial hypertension, and peripheral arterial disease. CONCLUSIONS: Available observational data supports the hypothesis that COPD is associated with an increased risk of CVD.
PMID: 23722528 [PubMed - as supplied by publisher]