慢性阻塞性肺疾病患者的心血管疾病负担。

Burden of cardiovascular disease in chronic obstructive pulmonary disease.

机构信息

Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio.

Department of Pulmonary and Critical Care Medicine, Cleveland Clinic, Cleveland, Ohio.

出版信息

Am J Prev Med. 2014 Aug;47(2):105-14. doi: 10.1016/j.amepre.2014.03.014. Epub 2014 Jul 3.

DOI:10.1016/j.amepre.2014.03.014

PMID:24997571

Abstract

BACKGROUND

Chronic obstructive pulmonary disease (COPD) and atherosclerotic vascular disease share several etiopathogenic factors.

PURPOSE

To compare the prevalence of self-reported cardiovascular and cerebrovascular disease (CCVD) between COPD and non-COPD subjects using the National Health and Nutrition Examination Survey (NHANES) database. Among subjects without pre-existent CCVD, the short-term and lifetime risks of future CCVD were also compared between the two groups.

METHODS

Pooled NHANES 2007-2010 data were analyzed in May 2012 and April 2013. Based on predicted Framingham risk, subjects without self-reported CCVD were classified as follows: high short-term risk, low short-term/high lifetime risk, and low short-term/low lifetime risk for future CCVD.

RESULTS

Estimated self-reported CCVD prevalence was 20.0% and 7.4% in COPD and non-COPD groups, respectively (p<0.001). On multivariable analysis, COPD was an independent risk factor for prevalent self-reported CCVD (prevalence ratio=1.4, 95% CI=1.1, 1.8). Among subjects without CCVD, there were significant differences in predicted future CCVD risk between the two groups. In the non-COPD group, prevalence of high short-term risk, low short-term/high lifetime risk, and low short-term/low lifetime risk was 18.9%, 62.7%, and 18.4%, respectively. In the COPD group, corresponding prevalence estimates were 35.8%, 53.2%, and 11.1%, respectively. Men and women had significantly different risk factor profiles for future CCVD.

CONCLUSIONS

The prevalence of self-reported CCVD was significantly higher in subjects with COPD than in those without COPD. Among subjects without pre-existent CCVD, the risk of future CCVD was significantly higher in the COPD group than in the non-COPD group.

摘要

背景

慢性阻塞性肺疾病（COPD）和动脉粥样硬化性血管疾病有几个共同的发病因素。

目的

利用国家健康和营养调查（NHANES）数据库比较 COPD 和非 COPD 患者报告的心血管和脑血管疾病（CCVD）的患病率。在无预先存在的 CCVD 的患者中，还比较了两组之间未来 CCVD 的短期和终生风险。

方法

2012 年 5 月和 2013 年 4 月分析了 2007-2010 年 NHANES 合并数据。根据预测的弗雷明汉风险，将无自我报告 CCVD 的患者分为以下几类：短期风险高、短期风险低但终生风险高、短期风险低且终生风险低。

结果

COPD 和非 COPD 组的自我报告 CCVD 患病率分别为 20.0%和 7.4%（p<0.001）。多变量分析显示，COPD 是自我报告 CCVD 的独立危险因素（患病率比=1.4，95%CI=1.1，1.8）。在无 CCVD 的患者中，两组之间未来 CCVD 风险存在显著差异。在非 COPD 组中，短期风险高、短期风险低但终生风险高和短期风险低且终生风险低的患病率分别为 18.9%、62.7%和 18.4%。在 COPD 组中，相应的患病率估计分别为 35.8%、53.2%和 11.1%。男性和女性未来 CCVD 的危险因素分布存在显著差异。