Association of Cardiovascular Disease With Respiratory Disease

• Published in: Journal of the American College of Cardiology Vol. 73; no. 17; pp. 2166 - 2177
• Main Authors: Carter, Paul, Lagan, Jakub, Fortune, Christien, Bhatt, Deepak L., Vestbo, Jørgen, Niven, Robert, Chaudhuri, Nazia, Schelbert, Erik B., Potluri, Rahul, Miller, Christopher A.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 07.05.2019; Elsevier Limited
• Subjects: Age Factors; Aged; Asthma; Asthma - diagnosis; Asthma - epidemiology; Cardiology; Cardiovascular; Cardiovascular diseases; Cardiovascular Diseases - diagnosis; Cardiovascular Diseases - epidemiology; Case-Control Studies; Cause of Death; Chronic obstructive pulmonary disease; Comorbidity; Congestive heart failure; Coronary artery disease; England; Female; Fibrillation; Health risk assessment; Heart failure; Humans; interstitial lung fibrosis; Ischemia; ischemic heart disease; Kaplan-Meier Estimate; Lung diseases; Lung Diseases, Interstitial - diagnosis; Lung Diseases, Interstitial - epidemiology; Male; Middle Aged; Mortality; Obstructive lung disease; Prevalence; Proportional Hazards Models; Pulmonary Disease, Chronic Obstructive - diagnosis; Pulmonary Disease, Chronic Obstructive - epidemiology; Respiratory diseases; Respiratory Tract Diseases - diagnosis; Respiratory Tract Diseases - epidemiology; Sex Factors; Studies; Survival Analysis; Vascular diseases; England; United Kingdom > UK; ILD; heart failure; ICD-10; OR; IHD; AF; CI; interstitial lung fibrosis; ischemic heart disease; asthma; HR; OPCS-4; PCI; NHS; CABG; HF; chronic obstructive pulmonary disease; COPD; PVD; odds ratio; peripheral vascular disease; Office of Population Censuses and Surveys Classification of Interventions and Procedures; National Health Service; atrial fibrillation; percutaneous coronary intervention; International Classification of Disease-10th edition; interstitial lung disease; coronary artery bypass grafting; hazard ratio; confidence interval
• ISSN: 0735-1097; 1558-3597; 1558-3597
• DOI: 10.1016/j.jacc.2018.11.063

The relationship between respiratory diseases and individual cardiovascular diseases, and the impact of cardiovascular diseases on mortality in patients with respiratory disease, are unclear. This study sought to determine the relationship between chronic obstructive pulmonary disease (COPD), asthma and interstitial lung disease (ILD), and individual cardiovascular diseases, and evaluate the impact of individual cardiovascular diseases on all-cause mortality in respiratory conditions. The authors conducted a cohort study of all patients admitted to 7 National Health Service hospitals across the North West of England, between January 1, 2000, and March 31, 2013, with relevant respiratory diagnoses, with age-matched and sex-matched control groups. A total of 31,646 COPD, 60,424 asthma, and 1,662 ILD patients were included. Control groups comprised 158,230, 302,120, and 8,310 patients, respectively (total follow-up 2,968,182 patient-years). COPD was independently associated with ischemic heart disease (IHD), heart failure (HF), atrial fibrillation, and peripheral vascular disease, all of which were associated with all-cause mortality (e.g., odds ratio for the association of COPD with HF: 2.18 [95% confidence interval (CI): 2.08 to 2.26]; hazard ratio for the contribution of HF to mortality in COPD: 1.65 [95% CI: 1.61 to 1.68]). Asthma was independently associated with IHD, and multiple cardiovascular diseases contributed to mortality (e.g., HF hazard ratio: 1.81 [95% CI: 1.75 to 1.87]). ILD was independently associated with IHD and HF, both of which were associated with mortality. Patients with lung disease were less likely to receive coronary revascularization. Lung disease is independently associated with cardiovascular diseases, particularly IHD and HF, which contribute significantly to all-cause mortality. However, patients with lung disease are less likely to receive coronary revascularization. [Display omitted]