Control of Cardiovascular Risk Factors in Patients with Chronic Obstructive Pulmonary Disease.
Ann Am Thorac Soc
; 19(7): 1102-1111, 2022 07.
Article
em En
| MEDLINE
| ID: mdl-35007497
ABSTRACT
Rationale Cardiovascular disease accounts for one-third of deaths in patients with chronic obstructive pulmonary disease (COPD). Better control of cardiovascular risk factors in primary care could improve outcomes. Objectives:
To define the prevalence, monitoring, treatment, and control of risk factors in patients with COPD.Methods:
Repeated cross-sectional analysis of primary care electronic medical records for all patients with COPD in the Canadian Primary Care Sentinel Surveillance Network from 2013 to 2018 (n = 32,695 in 2018). A control group was matched 11 for age, sex, and rural residence (n = 32,638 in 2018). Five risk factors were defined using validated definitions including laboratoryresults:
hypertension, dyslipidemia, diabetes, obesity, and smoking.Results:
All risk factors were more common in patients with COPD compared with matched control subjects, including hypertension (52.3% vs. 44.9%), dyslipidemia (62.0% vs. 57.8%), diabetes (25.0% vs. 20.2%), obesity (40.8% vs. 36.8%), and smoking (40.9% vs. 11.4%), respectively. The mean Framingham risk score was 20.6% versus 18.6%, with 53.8% of patients with COPD being high risk (⩾20%). Monitoring of risk factors within the last year in patients with COPD in 2018 was suboptimal 71.8% hypertension, 39.4% dyslipidemia, 74.5% diabetes, 52.3% obesity. Smoking status was infrequently recorded in the electronic record. In those monitored, guideline recommended targets were achieved in 60.8%, 46.6%, 57.4%, 10.6% and 12.0% for each risk factor. Cardiovascular therapies including angiotensin-converting enzyme inhibitors (69%), statins (69%), and smoking cessation therapies (27%) were underused.Conclusions:
In patients with COPD, major cardiovascular risk factors are common, yet inadequately monitored, undertreated, and poorly controlled. Strategies are needed to improve comprehensive risk factor management proven to reduce cardiovascular morbidity and mortality.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Doenças Cardiovasculares
/
Doença Pulmonar Obstrutiva Crônica
/
Dislipidemias
/
Hipertensão
Tipo de estudo:
Etiology_studies
/
Guideline
/
Observational_studies
/
Prevalence_studies
/
Risk_factors_studies
Limite:
Humans
País/Região como assunto:
America do norte
Idioma:
En
Revista:
Ann Am Thorac Soc
Ano de publicação:
2022
Tipo de documento:
Article