Cardiovascular Risk in Patients with Chronic Obstructive Pulmonary Disease: A Systematic Review

Author:

Sá-Sousa Ana12ORCID,Rodrigues Cidália3ORCID,Jácome Cristina12ORCID,Cardoso João45,Fortuna Inês1ORCID,Guimarães Miguel6ORCID,Pinto Paula78ORCID,Sarmento Pedro Morais9ORCID,Baptista Rui10111213

Affiliation:

1. MTG Research and Development Lab, 4200-604 Porto, Portugal

2. Center for Health Technology and Services Research-CINTESIS@RISE, MEDCIDS-Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, 4200-450 Porto, Portugal

3. Pulmonology Department, Unidade Local De Saúde de Coimbra, 3004-561 Coimbra, Portugal

4. Pulmonology Department, Unidade Local de Saúde São José, 1150-199 Lisboa, Portugal

5. NOVA Medical School, Nova University Lisbon, 1169-056 Lisboa, Portugal

6. Pulmonology Department, Unidade Local de Saúde de Gaia e Espinho, 4434-502 Vila Nova de Gaia, Portugal

7. Chest Department, Unidade Local De Saúde de Santa Maria, 1649-035 Lisboa, Portugal

8. Environmental Health Institute (ISAMB), Faculty of Medicine, University of Lisbon, 1649-028 Lisboa, Portugal

9. Department of Internal Medicine, Heart Failure Day Hospital, Hospital da Luz de Lisboa, 1500-650 Lisboa, Portugal

10. Department of Cardiology, Unidade Local De Saúde de Entre o Douro e Vouga, 4520-211 Santa Maria da Feira, Portugal

11. Faculty of Medicine, University of Coimbra, 3000-075 Coimbra, Portugal

12. Center for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, 3000-548 Coimbra, Portugal

13. Clinical Academic Center of Coimbra (CACC), 3004-531 Coimbra, Portugal

Abstract

Background/Objectives: A comprehensive and up-to-date review on cardiovascular disease (CVD) risk in patients with COPD is needed. Therefore, we aimed to systematically review the risk of a range of CVD in patients with COPD. Methods: We searched three databases (Pubmed, Web of Science, SCOPUS) from inception to September 2023 using terms related to COPD and CVD. Observational studies were included if they (1) were conducted in adults with a diagnosis of COPD based on the GOLD criteria, spirometry, physician diagnosis, or review of electronic health records; (2) reported the risk of CVD, namely of myocardial infarction (MI), ischaemic heart disease (IHD), atrial fibrillation (AF), heart failure, cerebrovascular disease, pulmonary hypertension, and peripheral vascular disease, compared with a control population using a measure of risk. A narrative synthesis was used. Results: Twenty-four studies from 2015 to 2023, mainly from Europe (n = 17), were included. A total of 3,485,392 patients with COPD (43.5–76.0% male; 63.9–73.5 yrs) and 31,480,333 (40.0–55.4% male, 49.3–70.0 yrs) controls were included. A higher risk of CVD in patients with COPD was evident regarding overall CVD, MI, IHD, heart failure, and angina. Higher risks of arrhythmia and AF, stroke, sudden cardiac death/arrest, pulmonary embolism, pulmonary hypertension, and peripheral vascular disease were also found, although based on a small amount of evidence. Conclusions: Patients with COPD have a higher risk of CVD than the general population or matched controls. This review underscores the need for vigilant and close monitoring of cardiovascular risk in individuals with COPD to inform more precise preventive strategies and targeted interventions to enhance their overall management.

Funder

AstraZeneca

Publisher

MDPI AG

Reference56 articles.

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