160715 COPD as independent risk factor for cardiovascular morbidity: An adjusted analysis of a probability sample of the US civilian population

Wednesday, November 7, 2007: 9:05 AM

Joseph Finkelstein, MD, PhD , School of Medicine, Department of Medicine, Johns Hopkins University, Baltimore, MD
Fang Liu, MPH , Department of Epidemiology and Preventive Medicine, University of Maryland, Baltimore, MD
Janaki Deepak , Department of Epidemiology and Preventive Medicine, University of Maryland, Baltimore, MD
     
OBJECTIVE: To study whether patients with Chronic Obstructive Pulmonary Disease (COPD) are at increased risk of cardiovascular diseases.

BACKGROUND: Recent studies described association between COPD and increased risk of cardiovascular diseases (CVD). None of these studies accounted for socio-demographic factors, health behaviors, and patient comorbidities simultaneously in their analysis.

DESIGN/METHODS: Subjects of age 40 years and older (N=18554) from the Sample Adult file of the 2002 National Health Interview Survey (NHIS) were included in the analysis. Chi-square tests and odds ratios (OR) were utilized to compare the data. Multiple logistic regression was employed to analyze association between COPD and CVD with simultaneous control for socio-demographic factors (age, gender, race, marital status, education, income), health behaviors (tobacco use, alcohol consumption, physical activity), and patient comorbidities. The analysis employed NHIS sampling weights to generate data representative of the entire US population.

RESULTS: The COPD population had increased prevalence of CVD (70.7% vs. 45.2%, p<0.0001). Adjusted logistic regression showed that COPD patients (N=1359) were at higher risk of having coronary heart disease (OR=2.1, 95% CI 1.7±2.6), angina (OR=2.4, 95% CI 1.9±3.0), myocardial infarction (OR=2.3, 95% CI 1.8±2.9), stroke (OR=1.6, 95% CI 1.2±2.2), congestive heart failure (OR=4.1, 95% CI 3.1±5.3), poor circulation in lower extremities (OR=2.4, 95% CI 2.0±2.9), hypertension (OR=1.6, 95% CI 1.4±1.8), and arrhythmia (OR=2.5, 95% CI 2.1±2.9). Overall, the presence of COPD increased the odds of having CVD by a factor of 2.3 (95% CI 1.9±2.7).

CONCLUSIONS: These findings support the conclusion that COPD is an independent risk factor for CVD.

Learning Objectives:
1. Evaluate COPD as independent risk factor for cardiovascular morbidity 2. Discuss use of National Health Interview Survey for CVD risk assessment modeling 3. List adjusted odds ratio for major cardiovascular diseases in COPD patients

Keywords: Cardiorespiratory, Epidemiology

Presenting author's disclosure statement:

Any relevant financial relationships? No
Any institutionally-contracted trials related to this submission?

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

See more of: Cardiovascular Disease Epidemiology
See more of: Epidemiology