Journal Information
Vol. 44. Issue 5.
Pages 233-238 (January 2008)
Share
Share
Download PDF
More article options
Vol. 44. Issue 5.
Pages 233-238 (January 2008)
Original Articles
Full text access
Cardiovascular Risk Factors in Chronic Obstructive Pulmonary Disease: Results of the ARCE Study
Visits
5182
Pilar de Lucas-Ramosa,
Corresponding author
plucasr.hgugm@salud.madrid.org

Correspondence: Dr P. de Lucas-Ramos Servicio de Neumología, Hospital General Universitario Gregorio Marañón Dr. Esquerdo, 46 28007 Madrid, Spain
, José Luis Izquierdo-Alonsob, José Miguel Rodríguez-González Moroa, José María Bellón-Canoc, Julio Ancochea-Bermúdezd, Myrian Calle-Rubioe, Eduardo Calvo-Corbellaf, Jesús Molina-Parísg, Esteban Pérez-Rodríguezh, Sonia Ponsi
a Servicio de Neumología, Hospital General Universitario Gregorio Marañón, Madrid, Spain
b Servicio de Neumología, Hospital Universitario, Guadalajara, Spain
c Unidad de Investigación, Hospital General Universitario Gregorio Marañón, Madrid, Spain
d Servicio de Neumología, Hospital Universitario La Princesa, Madrid, Spain
e Servicio de Neumología, Hospital Universitario Clínico de San Carlos, Madrid, Spain
f Centro de Salud Universitario Pozuelo de Alarcón, Madrid, Spain
g Centro de Salud Francia, Madrid, Spain
h Servicio de Neumología, Hospital Universitario Ramón y Cajal, Madrid, Spain
i Departamento Médico, Laboratorios Esteve, Barcelona, Spain
Ver más
This item has received
Article information
Objective

Cardiovascular disease is a common cause of death in patients with chronic obstructive pulmonary disease (COPD). It is not clear whether the high cardiovascular comorbidity is due to an increase in traditional risk factors or whether, in contrast, COPD can be considered an independent risk factor. The aim of this study was to analyze the prevalence of risk factors and cardiovascular comorbidity in a community-based population treated for COPD.

Patients and methods

This was a concurrent multicenter, cross-sectional study that included 572 patients with confirmed diagnosis of COPD. Information on cardiovascular risk factors and comorbidity was collected by extracting data from the medical records of the participating center.

Results

The mean (SD) forced expiratory volume in 1 second (FEV1) was 53.7% (16.85%) of predicted and the ratio of FEV1 to forced vital capacity was 57.9% (10.9%). Hypertension was reported in 53%, obesity in 27%, dyslipidemia in 26%, and diabetes in 23% of the patients. The prevalence of risk factors was not related to disease severity, but there was a trend towards an association with age. In the study group, 16.4% had ischemic heart disease, 7% cerebrovascular disease, and 17% peripheral vascular disease. Cardiovascular disease was not associated with COPD severity, but such an association was reported for age and traditional risk factors.

Conclusions

Cardiovascular risk factors are highly prevalent in patients with COPD. The prevalence of cardiovascular and cerebrovascular disease exceeds that reported in the general population. No relationship was found between the severity of airflow obstruction and the presence of cardiovascular comorbidity.

Key words:
COPD
Cardiovascular risk
Prevalence
Objetivo

La enfermedad cardiovascular es una causa de muerte frecuente en los pacientes con enfermedad pulmonar obstructiva crónica (EPOC). No está claro si el exceso de comorbilidad cardiovascular se relaciona con un incremento de factores de riesgo clásicos o si, por el contrario, la EPOC puede considerarse un factor de riesgo independiente. El objetivo de este estudio ha sido analizar la prevalencia de factores de riesgo y comorbilidad cardiovascular en una población atendida en la comunidad por presentar EPOC.

Pacientes y métodos

Se ha realizado un estudio multicéntrico, concurrente y transversal, en el que se incluyó a 572 pacientes con diagnóstico confirmado de EPOC. Se recogieron datos de factores de riesgo y comorbilidad cardiovascular extraídos de la historia clínica del centro.

Resultados

El valor medio ± desviación estándar del volumen espiratorio forzado en el primer segundo era del 53,7 ± 16,85% y la relación volumen espiratorio forzado en el primer segundo/capacidad vital forzada del 57,9 ± 10,9%. La prevalencia de hipertensión arterial era del 53%, la de obesidad del 27%, la de dislipemia del 26% y la de diabetes del 23%. La prevalencia de factores de riesgo no se relacionó con la gravedad de la enfermedad, pero sí había una tendencia de asociación con la edad. La prevalencia de cardiopatía isquémica fue del 16,4%, la de enfermedad cerebrovascular del 7% y la de enfermedad vascular periférica del 17%. La prevalencia de comorbilidad vascular no se relacionó con la gravedad de la enfermedad, pero sí con la edad y los factores de riesgo clásicos.

Conclusiones

Los pacientes con EPOC muestran una elevada prevalencia de factores de riesgo cardiovascular. La prevalencia de enfermedad cardiovascular y cerebrovascular excede la comunicada en población general. No se ha observado relación entre la gravedad de la obstrucción al flujo aéreo y la presencia de comorbilidad cardiovascular.

Palabras clave:
EPOC
Riesgo cardiovascular
Prevalencia
Full text is only aviable in PDF
References
[1]
Instituto Nacional de Estadística.
Tasas de mortalidad según causa, año 2002.
[2]
V Sobradillo, M Miravitlles, R Gabriel, JF Masa, JL Viejo, L Fernández-Fau.
Geographic variations in prevalence and underdiagnosis of COPD. Results of the IBERPOC Multicentre Epidemiological Study.
Chest, 118 (2000), pp. 981-989
[3]
AL Hansell, JA Walk, JB Soriano.
What do chronic obstructive pulmonary disease patients die from? A multiple cause coding analysis.
Eur Respir J, 22 (2003), pp. 809-814
[4]
L Huiart, P Erns, S Suissa.
Cardiovascular morbidity and mortality in COPD.
Chest, 128 (2005), pp. 2640-2646
[5]
J Hole, GC Watt, Davey-Smith, CL Hart, CR Gillis, VM Hawthorne.
Impaired lung function and mortality risk in men and women: findings from the Renfrew and Paisley prospective population study.
BMJ, 313 (1996), pp. 711-715
[6]
S Curkendall, C DeLuise, JK Jones, S Lanes, MR Stang, E Goehring, et al.
Cardiovascular disease in patients with chronic obstructive pulmonary disease, Saskatchewan Canada cardiovascular disease in COPD patients.
Ann Epidemiol, 16 (2006), pp. 63-70
[7]
LM Fabbri, KF Rabe.
From COPD to chronic systemic inflammatory syndrome.
[8]
J Zielinski, W MacNee, J Wedzicha, N Ambrosino, A Braghiroli, J Dolensky, et al.
Causes of death in patients with COPD and chronic respiratory failure.
Monaldi Arch Chest Dis, 52 (1997), pp. 43-47
[9]
DM Mannino, DE Doherty, S Buist.
Global Initiative on Obstructive Lung Disease (GOLD) classification of lung disease and mortality: findings from the atherosclerosis risk in communities (ARIC) study.
Respir Med, 100 (2006), pp. 115-122
[10]
R Nicholas, MD Anthonisen, A Melissa, MS Skeans, MD Wise, J Manfreda, et al.
The effects of a smoking cessation intervention on 14.5-year mortality.
Ann Intern Med, 142 (2005), pp. 233-239
[11]
PM Calverley, JA Anderson, B Celli, GT Ferguson, C Jenkins, PW Jones, TORCH, et al.
Salmeterol and fluticasone propionate and survival in chronic obstructive pulmonary disease.
N Engl J Med, 356 (2007), pp. 775-789
[12]
JL Izquierdo, R Arroyo.
Enfermedad pulmonar obstructiva crónica y riesgo cardiovascular.
Arch Bronconeumol, 41 (2005), pp. 410-412
[13]
VM Pinto-Plata, H Mullerova, JF Toso, M Feudjo-Tepie, JB Soriano, RS Vessey, et al.
C-reactive protein in patients with COPD, control smokers and non-smokers.
Thorax, 61 (2006), pp. 23-28
[14]
JP De Torres, E Córdoba-Lanus, C López-Aguilar, M Muros de Fuentes, A Montejo de Garcini, A Aguirre-Jaime, et al.
C-reactive protein levels and clinically important predictive outcomes in stable COPD patients.
Eur Respir J, 27 (2006), pp. 902-907
[15]
JL Izquierdo, C Almonacid, T Parra, J Pérez.
Inflamación y estrés oxidativo en dos fenotipos de EPOC.
Arch Bronconeumol, 42 (2006), pp. 332-337
[16]
P Jousilahti, E Vartiainen, J Tuomilehto, P Puska.
Symptoms of chronic bronchitis and the risk of coronary disease.
[17]
HJ Schünemann, J Dorn, BJB Grant, W Winkelstein, M Trevisan.
Pulmonary function is a long-term predictor of mortality in the general population: 29-year follow-up of the Buffalo Health Study.
Chest, 118 (2000), pp. 656-664
[18]
DM Mannino, AS Buist, TL Petty, PL Enright, SC Redd.
Lung function and mortality in the United States: data from the First National Health and Nutrition Examination Survey follow up study.
Thorax, 58 (2003), pp. 388-393
[19]
J García-Aymerich, P Lange, M Benet, P Schnohr, JM Anto.
Regular physical activity reduces hospital admission and mortality in chronic obstructive pulmonary disease: a population based cohort study.
Thorax, 61 (2006), pp. 772-778
[20]
JB Soriano, GT Visick, H Muellerova, N Payvandi, AL Hansell.
Patterns of comorbidities in newly diagnosed COPD and asthma in the primary care.
Chest, 128 (2005), pp. 2099-2107
[21]
DW Mapel, JS Hurley, FJ Frost, HV Petersen, MA Picchi, DB Coultas.
Health care utilization in chronic obstructive pulmonary disease. A case-control study in a health maintenance organization.
Arch Intern Med, 160 (2000), pp. 2653-2658
[22]
R Antonelli-Incalzi, L Fuso, M De Rosa, F Forastiere, E Rapiti, B Nardecchia, et al.
Co-morbidity contributes to predict mortality of patients with chronic obstructive pulmonary disease.
Eur Respir J, 10 (1997), pp. 2794-2800
[23]
SM Curkendall, S Lanes, C De Luise, MR Stang, JK Jones, D She, et al.
Chronic obstructive pulmonary disease severity and cardiovascular outcomes.
Eur J Epidemiol, 21 (2006), pp. 803-813
[24]
J Marrugat, I Subirana, E Comín, C Cabezas, J Vila, R Elosúa, for the VERIFICA investigators, et al.
Validity of an adaptation of the Framingham cardiovascular risk: the VERIFICA study.
J Epidemiol Community Health, 61 (2007), pp. 40-47
[25]
C Castell, R Tresserras, J Serra, A Godoy, G Lloveras, L Sallers.
Prevalence of diabetes in Catalonia (Spain): an oral glucose tolerance test-based population study.
Diabetes Res Clin Prac, 43 (1999), pp. 33-40
[26]
J Aranceta, C Pérez Rodríguez, LL Serra, L Ribas Barba, J Quiles Izquierdo, J Vioque, y el grupo colaborador para el estudio de la Obesidad en España, et al.
Prevalencia de la obesidad en España: resultados del estudio SEEDO 2000.
Med Clin (Barc), 120 (2003), pp. 608-612
[27]
F Villar Álvarez, JR Benegas Benegas, J Donado Campos, J Rodríguez Artalejo.
La enfermedad cardiovascular y sus factores de riesgo en España. Hechos y cifras. Informe de la Sociedad Española de Arteriosclerosis (SEA), ERGON, (2005),
[28]
J Marrugat, R Elosua, H Martí.
Epidemiología de la cardiopatía isquémica en España: estimaciones del número de casos y de las tendencias entre 1997 y 2005.
Rev Esp Cardiol, 55 (2002), pp. 337-346
[29]
MJ Medrano-Alfaro, R Boix-Martínez, E Cerrato Crespan, M Ramres Santa-Pau.
Incidencia y prevalencia de cardiopatía isquémica y enfermedad cerebrovascular en España: revisión sistemática de la literatura.
Rev Esp Salud Pública, 80 (2006), pp. 5-15

This study was conducted under the auspices of the Society of Pulmonology and Thoracic Surgery of Madrid (NEUMOMADRID) and sponsored by Laboratorios Esteve. Pilar de Lucas Ramos and José Luis Izquierdo Alonso have contributed equally to performing this study.

Copyright © 2008. Sociedad Española de Neumología y Cirugía Torácica (SEPAR)
Archivos de Bronconeumología
Article options
Tools

Are you a health professional able to prescribe or dispense drugs?