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© 2005 The American Thoracic Society
Chronic Obstructive Pulmonary Disease as a Risk Factor for Cardiovascular Morbidity and Mortality
Department of Medicine, University of British Columbia; and The James Hogg iCAPTURE Center for Cardiovascular and Pulmonary Research, St. Paul's Hospital, Vancouver, British Columbia, Canada
Correspondence and requests for reprints should be addressed to Don D. Sin, M.D., James Hogg iCAPTURE Center for Cardiovascular and Pulmonary Research, St. Paul's Hospital, Room #368A, 1081 Burrard Street, Vancouver, BC, V6Z 1Y7 Canada. E-mail: dsin{at}mrl.ubc.ca
Chronic obstructive pulmonary disease and other disorders, associated with reduced lung function, are strong risk factors for cardiovascular events, independent of smoking. Overall, when the lowest quintile of lung function, as measured by FEV1, is compared with the highest quintile, the risk of cardiovascular mortality increases by approximately 75% in both men and women. Having symptoms of chronic bronchitis alone increases the risk of coronary deaths by 50%. Reduced ratio of FEV1 to FVC by itself is a modest independent risk factor for coronary events, increasing the risk by 30%. However, if patients have ventricular arrhythmias, the risk of coronary events is increased twofold, suggesting that the cardiotoxic effects of obstructive airways disease are amplified in those who have underlying cardiac rhythm disturbances. In general, for every 10% decrease in FEV1, all-cause mortality increases by 14%, cardiovascular mortality increases by 28%, and nonfatal coronary event increases by almost 20%. These data indicate that chronic obstructive pulmonary disease is a powerful, independent risk factor for cardiovascular morbidity and mortality.
Key Words: cardiovascular disease • chronic obstructive pulmonary disease • epidemiology • FEV1 • lung function
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