Background: The relationship between respiratory diseases and individual cardiovascular diseases, and the impact of cardiovascular diseases on mortality in patients with respiratory disease, are unclear.
Objectives: To determine the relationship between chronic obstructive pulmonary disease (COPD), asthma and interstitial lung disease (ILD), and individual cardiovascular diseases, and evaluate the impact of individual cardiovascular diseases on all-cause mortality in respiratory conditions.
Methods: Cohort study of all patients admitted to seven National Health Service hospitals across the North West of England, between January 1st 2000 and March 31st 2013 with relevant respiratory diagnoses, with age and gender matched control groups.
Results: 31,646 COPD, 60,424 asthma and 1,662 ILD patients were included. Control groups comprised 158,230, 302,120 and 8,310 patients respectively (total follow up 2,968,182 patient-years). COPD was independently associated with ischemic heart disease (IHD), heart failure (HF), atrial fibrillation and peripheral vascular disease, all of which were associated with all-cause mortality (e.g. odds ratio for the association of COPD with HF 2.18 [95% confidence interval 2.08-2.26]; hazard ratio (HR) for the contribution of HF to mortality in COPD 1.65 [1.61-1.68]). Asthma was independently associated with IHD, and multiple cardiovascular diseases contributed to mortality (e.g. HF HR 1.81 [1.75-1.87]). ILD was independently associated with IHD and HF, both of which were associated with mortality. Patients with lung disease were less likely to receive coronary revascularization.
Conclusions: Lung disease is independently associated with cardiovascular diseases, particularly IHD and HF, which contribute significantly to all-cause mortality. However, patients with lung disease are less likely to receive coronary revascularization.