Introduction Patients with COPD have increased risk of cardiovascular (CV) disease compared to smokers without COPD,1 with over 25% of deaths CV related.2 Several CV risk calculators for the general population exist but it is unclear whether they are applicable for COPD.
Standard CV risk calculators do not identify the increased risk in patients with COPD.
Methods Subjects with a smoking history >10 pack years, with and without COPD, were assessed at clinical stability, COPD n = 191 and controls n = 106. Post-bronchodilator spirometry and blood pressure were performed, blood taken for lipids and self-reported medical and smoking history recorded. In those without documented established CV disease or diabetes (COPD n = 135 and controls n = 88), 10 year CV risk was calculated using ACC/AHA3 and NHLBI calculators.
Results Both groups were well matched for gender and mean arterial blood pressure (MAP), with the COPD group slightly older, Table 1. Mean CV risk scores were similar between patients with COPD and controls, Table 1, ACC/AHA p = 0.16 and NHLBI p = 0.59. When using an established cut-off point of 20% for high 10 year CV risk, similar proportions were identified as high risk: the ACC/AHA calculator - 37% of the patients with COPD and 33% of controls; and with the NHLBI calculator 15% of the patients with COPD and 10% of controls were identified as high-risk.
Discussion Although nearly double the proportion of patients with COPD compared to controls with a smoking history have current CV disease or diabetes in this cross-sectional study, the increased risk of future incident CV disease in patients with COPD was not identified using standard calculators.
Supported by a NIHR BRF Fellowship.
Feary, JR, et al. Thorax, 2010;65(11): p. 956-62
McGarvey, LP, et al. Thorax, 2007;62(5): p. 411-5
NHLBI Available from: http://cvdrisk.nhlbi.nih.gov/