Basel Pharmacoepidemiology Unit, Division of Clinical Pharmacy and Epidemiology, Department of Pharmaceutical Sciences, University of Basel, Basel, Switzerland.
Eur J Epidemiol. 2010 Apr;25(4):253-60. doi: 10.1007/s10654-010-9435-7. Epub 2010 Feb 27.
Previous large epidemiological studies reporting on the association between chronic obstructive pulmonary disease (COPD) and cardiovascular diseases mainly focussed on prevalent diseases rather than on the incidence of newly diagnosed cardiovascular outcomes. We used the UK-based General Practice Research Database (GPRD) to assess the prevalence and incidence of cardiovascular diseases in COPD patients aged 40-79 between 1995 and 2005, and we randomly matched COPD-free comparison patients to COPD patients. In nested-case control analyses, we compared the risks of developing an incident diagnosis of cardiac arrhythmias, venous thromboembolism, myocardial infarction, or stroke between patients with and without COPD, stratifying the analyses by COPD-severity, using COPD-treatment as proxy for disease severity. We identified 35,772 patients with COPD and the same number of COPD-free patients. Most cardiovascular diseases were more prevalent among COPD patients than among the comparison group of COPD-free patients. The relative risk estimates of developing an incident diagnosis of cardiac arrhythmia (OR 1.19, 95% CI 0.98-1.43), deep vein thrombosis (OR 1.35, 95% CI 0.97-1.89), pulmonary embolism (OR 2.51, 95% CI 1.62-3.87), myocardial infarction (OR 1.40, 95% CI 1.13-1.73), or stroke (OR 1.13, 95% CI 0.92-1.38), tended to be increased for patients with COPD as compared to COPD-free controls. The findings of this large observational study provide further evidence that patients with COPD are at increased risk for most cardiovascular diseases.
先前的大型流行病学研究报告表明，慢性阻塞性肺疾病（COPD）与心血管疾病之间存在关联，主要集中在已确诊的疾病上，而非新诊断的心血管疾病的发病率上。我们利用英国的全科医生研究数据库（GPRD）评估了 1995 年至 2005 年间年龄在 40-79 岁的 COPD 患者中心血管疾病的患病率和发病率，并随机匹配了无 COPD 的对照患者。在巢式病例对照分析中，我们比较了有和无 COPD 的患者发生心律失常、静脉血栓栓塞、心肌梗死或中风等新发诊断的风险，通过 COPD 严重程度对分析进行分层，使用 COPD 治疗作为疾病严重程度的替代指标。我们确定了 35772 例 COPD 患者和相同数量的无 COPD 患者。大多数心血管疾病在 COPD 患者中比在无 COPD 的对照组中更为常见。发生心律失常（OR 1.19，95%CI 0.98-1.43）、深静脉血栓形成（OR 1.35，95%CI 0.97-1.89）、肺栓塞（OR 2.51，95%CI 1.62-3.87）、心肌梗死（OR 1.40，95%CI 1.13-1.73）或中风（OR 1.13，95%CI 0.92-1.38）的风险比，COPD 患者相对于无 COPD 对照者往往更高。这项大型观察性研究的结果进一步证明，COPD 患者发生大多数心血管疾病的风险增加。
