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(Chest. 2005;128:2640-2646.)
© 2005 American College of Chest Physicians

Cardiovascular Morbidity and Mortality in COPD*

Laetitia Huiart, MD; Pierre Ernst, MD and Samy Suissa, PhD

* From the Division of Clinical Epidemiology, Royal Victoria Hospital and Department of Epidemiology and Biostatistics, McGill University, Montreal, Canada; and Laboratoire de Santé Publique EA 3279, Université de la Méditerranée and Département d’Oncogénétique, Institut Paoli-Calmettes, Marseille, France.

Correspondence to: Samy Suissa, PhD, Division of Clinical Epidemiology, Royal Victoria Hospital, 687 Pine Ave West, Ross 4.29, Montreal, QC, Canada, H3A 1A1; e-mail: samy.suissa{at}clinepi.mcgill.ca

Study objective: COPD and cardiovascular disease (CVD) share common risk factors. We undertook to estimate rates of hospitalization and death from CVD in COPD patients relative to the general population.

Design and setting: A cohort of patients ≥ 55 years old receiving a first treatment for COPD between 1990 and 1997 was formed from the Saskatchewan Health databases. All hospitalizations and deaths between cohort entry and the end of 1999 were identified.

Results: The cohort included 5,648 individuals and generated 23,426 person-years (PY) of follow-up. The overall rates of cardiovascular morbidity and mortality were 177.2 and 41 per 1,000 PY, respectively. Cardiovascular morbidity and mortality rates were higher in the COPD cohort than in the general population (standardized rate ratios of 1.9 and 2.0, respectively). More hospitalizations for CVD than for COPD itself were reported. Among CVDs, heart failure represented the most frequent cause of hospitalization (58.8 per 1,000 PY). CVD and more specifically ischemic heart disease (19.6 per 1,000 PY) were reported as a more frequent cause of death than COPD itself (15.5 per 1,000 PY).

Conclusion: CVD is more frequent in COPD patients than in the general population and may represent a burden greater than that of lung disease itself.

Key Words: cohort study • epidemiology • external comparisons • heart disease • morbidity • mortality






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