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Respiratory epidemiology
Original article
Bronchiectasis and the risk of cardiovascular disease: a population-based study
  1. Vidya Navaratnam1,2,3,
  2. Elizabeth R C Millett2,
  3. John R Hurst4,
  4. Sara L Thomas2,
  5. Liam Smeeth2,
  6. Richard B Hubbard1,
  7. Jeremy Brown4,
  8. Jennifer K Quint2,5
  1. 1Division of Epidemiology and Public Health, University of Nottingham, Nottingham, UK
  2. 2Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
  3. 3Department of Respiratory Medicine, University of Nottingham, Nottingham, UK
  4. 4Centre for Inflammation and Tissue Repair, University College London, London, UK
  5. 5Department of Respiratory Epidemiology, Occupational Medicine and Public Health, National Heart and Lung Institute, Imperial College London, London, UK
  1. Correspondence to Dr Vidya Navaratnam, Nottingham Respiratory Research Unit, Clinical Sciences Building, Nottingham City Hospital, Hucknall Road, Nottingham NG5 1PB, UK; vidya.navaratnam{at}nottingham.ac.uk

Abstract

Background There are limited data on the burden of cardiovascular comorbidities in people with bronchiectasis. Our cross-sectional study estimates the burden of pre-existing diagnoses of coronary heart disease (CHD) and stroke in people with bronchiectasis compared with the general population. The historical cohort study investigates if individuals with bronchiectasis are at increased risk of incident CHD and stroke events.

Methods We used primary care electronic records from the Clinical Practice Research Datalink. The cross-sectional study used logistic regression to quantify the association between bronchiectasis and recorded diagnoses of CHD or stroke. Cox regression was used to investigate if people with bronchiectasis experienced increased incident CHD and strokes compared with the general population, adjusting for age, sex, smoking habit and other risk factors for cardiovascular disease.

Results Pre-existing diagnoses of CHD (OR 1.33, 95% CI 1.25 to 1.41) and stroke (OR 1.92, 95% CI 1.85 to 2.01) were higher in people with bronchiectasis compared with those without bronchiectasis, after adjusting for age, sex, smoking and risk factors for cardiovascular disease. The rate of first CHD and stroke were also higher in people with bronchiectasis (HR for CHD 1.44 (95% CI 1.27 to 1.63) and HR for stroke 1.71 (95% CI 1.54 to 1.90)).

Conclusion The risk of CHD and stroke are higher among people with bronchiectasis compared with the general population. An increased awareness of these cardiovascular comorbidities in this population is needed to provide a more integrated approach to the care of these patients.

  • Bronchiectasis
  • Clinical Epidemiology

This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See: http://creativecommons.org/licenses/by/4.0/

https://doi.org/10.1136/thoraxjnl-2015-208188

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    Footnotes

    • Contributors VN and JKQ conceived and designed the study and were involved in the analyses of the data. VN, ERCM and JKQ were involved in the acquisition of the data. VN, ERCM, JRH, SLT, LS, RBH, JB and JKQ were involved in the interpretation of the data and in writing or revising the manuscript before submission. VN takes responsibility for the integrity of the work in this manuscript and is the guarantor of the manuscript.

    • Funding VN is funded by a National Institute for Health Research (NIHR) Academic Clinical Lecturership. SLT was funded by a NIHR Career Development Fellowship [CDF 2010-03-32]. University College London Hospitals/University College London received a proportion of funding from the Department of Health's NIHR Biomedical Research Centre's funding scheme. RBH is funded by the GSK/BLF chair of Epidemiological Respiratory Research. JKQ was funded on a MRC Population Health Scientist Fellowship (G0902135).

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

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