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CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD), COMORBID DISEASE, AND FOLLOW-UP HOSPITALIZATIONS IN A U.S. COHORT

University of Kentucky, Lexington, KY

PURPOSE: COPD is associated with important comorbid diseases, including cardiovascular disease, diabetes, and hypertension. We analyzed cross-sectional and longitudinal data from participants in the Atherosclerosis Risk in Communities Study (ARIC) and the Cardiovascular Health Study (CHS).

METHODS: We limited our analysis to 22,056 participants aged 45 and older at baseline on whom we had complete data. We stratified the sample based on prebronchodilator baseline lung function data, according to GOLD criteria, including a "restrictive" category (FEV1/FVC >70% and FVC < 80%). We identified subjects who, at baseline, had cardiovascular disease, diabetes, or hypertension. We then searched for the following outcomes over 5 years of follow-up: hospitalizations for heart disease, congestive heart failure, stroke, and death.

RESULTS: We found lung function impairment to be associated with more comorbid disease. In logistic regression models adjusting for age, sex, race, smoking status, body mass index and education, people with GOLD stage 3 or 4 COPD had a higher prevalence of cardiovascular disease (odds ratio [OR] 1.7, 95% confidence interval [CI] 1.3, 2.4), diabetes (OR 1.6, 95% CI 1.3, 2.0), and hypertension (OR 1.6, 95% CI 1.4, 1.9). Each comorbid disease was associated with a high rate of hospitalizations and mortality that was worse in people with impaired lung function (data for diabetes in Table).

CONCLUSION: Lung function impairment, in this population, is associated with a higher risk of cardiovascular disease, diabetes, and hypertension. In addition, the presence of these comorbid diseases is associated with an increased risk of hospitalizations for heart disease, congestive heart failure, stroke, and death.

CLINICAL IMPLICATIONS: Patients with respiratory impairment are at a higher risk for comorbid disease.

DISCLOSURE: David Mannino, No Product/Research Disclosure Information; University grant monies None; Grant monies (from sources other than industry) None; Grant monies (from industry related sources) Novartis, GlaxoSmithKline, Pfizer; Shareholder None; Employee None; Fiduciary position (of any organization, association, society, etc, other than ACCP None; Consultant fee, speaker bureau, advisory committee, etc. Pfizer, GlaxoSmithKline, Dey, Sepracor; Other None