Coronary heart disease and heart failure in asthma, COPD and asthma-COPD overlap
IntroductionWe investigated risk of coronary heart disease and heart failure in phenotypes of obstructive airway disease.MethodsAmong 91 692 participants in the Copenhagen General Population Study, 42 058 individuals were classified with no respiratory disease, and 11 988 individuals had different p...
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doaj-8cd2751267e843a7add346b00c5687032021-02-01T14:30:05ZengBMJ Publishing GroupBMJ Open Respiratory Research2052-44392020-05-017110.1136/bmjresp-2019-000470Coronary heart disease and heart failure in asthma, COPD and asthma-COPD overlapTruls Sylvan IngebrigtsenJacob Louis MarottPeter Lange0Department of Internal Medicine, Section of Respiratory Medicine, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, DenmarkIntroductionWe investigated risk of coronary heart disease and heart failure in phenotypes of obstructive airway disease.MethodsAmong 91 692 participants in the Copenhagen General Population Study, 42 058 individuals were classified with no respiratory disease, and 11 988 individuals had different phenotypes of obstructive airways disease: asthma with early onset or late-onset, chronic obstructive pulmonary disease (COPD) with forced expiratory volume in one second (FEV1) above or below 50% of predicted value (%p) or asthma-COPD overlap (ACO).ResultsDuring a mean follow-up of 5.7 years we registered 3584 admissions for coronary heart disease and 1590 admissions for heart failure. Multivariable Cox regression analyses of time to first admission were used with a two-sided p value of 0.05 as significance level. Compared with no respiratory disease the highest risks of coronary heart disease and heart failure were observed in ACO with late-onset asthma and FEV1 <50% p, HR=2.2 (95% CI 1.6 to 3.0), and HR=2.9 (95% CI 2.0 to 4.3), respectively. In COPD with FEV1 above 50% p the HRs were 1.3 (95% CI 1.2 to 1.5) for coronary heart disease and 1.9 (95% CI 1.6 to 2.3) for heart failure. Asthma associated with increased risks of coronary heart disease and heart failure, however, in asthma without allergy the HR was 1.1 (95% CI 0.7 to 1.6) for coronary heart disease while individuals with allergy had an HR of 1.4 (95% CI 1.1 to 1.6).ConclusionsRisks of coronary heart disease and heart failure were increased in asthma, COPD and ACO. In asthma, the risk of coronary heart disease depended on presence of allergy. We suggest that cardiovascular risk factors should be assessed systematically in individuals with obstructive airway disease with the potential to facilitate targeted treatments.https://bmjopenrespres.bmj.com/content/7/1/e000470.full |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Truls Sylvan Ingebrigtsen Jacob Louis Marott Peter Lange |
spellingShingle |
Truls Sylvan Ingebrigtsen Jacob Louis Marott Peter Lange Coronary heart disease and heart failure in asthma, COPD and asthma-COPD overlap BMJ Open Respiratory Research |
author_facet |
Truls Sylvan Ingebrigtsen Jacob Louis Marott Peter Lange |
author_sort |
Truls Sylvan Ingebrigtsen |
title |
Coronary heart disease and heart failure in asthma, COPD and asthma-COPD overlap |
title_short |
Coronary heart disease and heart failure in asthma, COPD and asthma-COPD overlap |
title_full |
Coronary heart disease and heart failure in asthma, COPD and asthma-COPD overlap |
title_fullStr |
Coronary heart disease and heart failure in asthma, COPD and asthma-COPD overlap |
title_full_unstemmed |
Coronary heart disease and heart failure in asthma, COPD and asthma-COPD overlap |
title_sort |
coronary heart disease and heart failure in asthma, copd and asthma-copd overlap |
publisher |
BMJ Publishing Group |
series |
BMJ Open Respiratory Research |
issn |
2052-4439 |
publishDate |
2020-05-01 |
description |
IntroductionWe investigated risk of coronary heart disease and heart failure in phenotypes of obstructive airway disease.MethodsAmong 91 692 participants in the Copenhagen General Population Study, 42 058 individuals were classified with no respiratory disease, and 11 988 individuals had different phenotypes of obstructive airways disease: asthma with early onset or late-onset, chronic obstructive pulmonary disease (COPD) with forced expiratory volume in one second (FEV1) above or below 50% of predicted value (%p) or asthma-COPD overlap (ACO).ResultsDuring a mean follow-up of 5.7 years we registered 3584 admissions for coronary heart disease and 1590 admissions for heart failure. Multivariable Cox regression analyses of time to first admission were used with a two-sided p value of 0.05 as significance level. Compared with no respiratory disease the highest risks of coronary heart disease and heart failure were observed in ACO with late-onset asthma and FEV1 <50% p, HR=2.2 (95% CI 1.6 to 3.0), and HR=2.9 (95% CI 2.0 to 4.3), respectively. In COPD with FEV1 above 50% p the HRs were 1.3 (95% CI 1.2 to 1.5) for coronary heart disease and 1.9 (95% CI 1.6 to 2.3) for heart failure. Asthma associated with increased risks of coronary heart disease and heart failure, however, in asthma without allergy the HR was 1.1 (95% CI 0.7 to 1.6) for coronary heart disease while individuals with allergy had an HR of 1.4 (95% CI 1.1 to 1.6).ConclusionsRisks of coronary heart disease and heart failure were increased in asthma, COPD and ACO. In asthma, the risk of coronary heart disease depended on presence of allergy. We suggest that cardiovascular risk factors should be assessed systematically in individuals with obstructive airway disease with the potential to facilitate targeted treatments. |
url |
https://bmjopenrespres.bmj.com/content/7/1/e000470.full |
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