Common Lung Diseases Associated With Cardiovascular Risk

According to a recent study, patients with common lung diseases such as asthma, chronic obstructive pulmonary disease (COPD), and lung fibrosis are significantly more likely to develop cardiovascular disease.

The study sought to determine the relationship between COPD, asthma, and interstitial lung disease (ILD) with individual cardiovascular diseases and to evaluate the impact of individual cardiovascular diseases on all-cause mortality in respiratory conditions. A total of 31,646 patients with COPD, 60,424 patients with asthma, and 1662 patients with ILD were included in the study, with control groups comprised of 158,230, 302,120, and 8310 patients, respectively.

“The cardiovascular diseases which we found in these respiratory patients are serious and not only have a large impact on patients’ day-to-day lives but also have high mortality rates. These mortality rates are compounded by having both heart and lung conditions. For example, COPD and fibrosis patients were on average 60% more likely to die after developing heart failure than those with heart failure but no lung disease,” Rahul Potluri, MBChB, founder of the ACALM Study Unit and clinical lecturer at Aston Medical School in Birmingham, England, said in a statement.

The results demonstrated independent associations between COPD and increased likelihood for ischemic heart disease, heart failure, atrial fibrillation, and peripheral vascular disease. Asthma was associated with increased likelihood for ischemic heart disease, and ILD was associated with an increased likelihood for ischemic heart disease and heart failure.

“The most striking findings were that when compared to patients without lung disease, risk of ischemic heart disease was increased by 50% in asthmatics, 60% in fibrosis and 75% in COPD. Similarly, the risk of [heart failure], which is a serious chronic condition [that] happens when the heart struggles to pump enough blood around the body, was a massive 2.2-fold greater in COPD and fibrosis patients,” Paul Carter, MBChB, from the University of Cambridge, said in a statement.

Additionally, patients with lung disease were also less likely to receive coronary revascularization via percutaneous coronary intervention or coronary artery bypass graft surgery than those without lung disease, even though revascularization was associated with a lower risk for death, according to the study.

Potluri said, “Despite the increased risk of heart disease, patients with lung diseases were less likely to receive heart treatments. Potential reasons include difficulties in diagnosis due to similar symptoms, and heart treatments having higher rates of complications in patients with lung diseases. Further work is required to understand this finding in more detail and how it could be addressed.”

Reference

Carter P, Lagan J, Fortune C, et al. Association of cardiovascular disease with respiratory disease [published May 7, 2019]. J Am Coll Cardiol. doi: 10.1016/j.jacc.2018.11.063.