Prevalence and outcomes of diabetes, hypertension and cardiovascular disease in COPD

TLDR

Chronic obstructive pulmonary disease (COPD) is associated with important chronic comorbid diseases, including cardiovascular disease, diabetes and hypertension. The study analysed data from 20,296 adults aged ≥45 years in the ARIC and CHS cohorts, stratifying participants by baseline lung function per modified GOLD criteria and examining comorbid disease, death, and hospitalisations over five years. Lung function impairment was linked to a higher prevalence of diabetes, hypertension, and cardiovascular disease, and comorbid disease increased the risk of hospitalisation and mortality, especially among those with severe COPD.

Abstract

Chronic obstructive pulmonary disease (COPD) is associated with important chronic comorbid diseases, including cardiovascular disease, diabetes and hypertension. The present study analysed data from 20,296 subjects aged ≥45 yrs at baseline in the Atherosclerosis Risk in Communities Study (ARIC) and the Cardiovascular Health Study (CHS). The sample was stratified based on baseline lung function data, according to modified Global Initiative for Obstructive Lung Disease (GOLD) criteria. Comorbid disease at baseline and death and hospitalisations over a 5-yr follow-up were then searched for. Lung function impairment was found to be associated with more comorbid disease. In logistic regression models adjusting for age, sex, race, smoking, body mass index and education, subjects with GOLD stage 3 or 4 COPD had a higher prevalence of diabetes (odds ratio (OR) 1.5, 95% confidence interval (CI) 1.1–1.9), hypertension (OR 1.6, 95% CI 1.3–1.9) and cardiovascular disease (OR 2.4, 95% CI 1.9–3.0). Comorbid disease was associated with a higher risk of hospitalisation and mortality that was worse in people with impaired lung function. Lung function impairment is associated with a higher risk of comorbid disease, which contributes to a higher risk of adverse outcomes of mortality and hospitalisations.