Undiagnosed COPD in Patients with Established Cardiovascular Diseases:Prevalence, Symptoms Profiling and Functional StatusLi-Cher Loh1*, Narentharen Selvarajah1, Shanthiny Mohan1, Wai-Sun Choo1 and Ismail Omar2
- *Corresponding Author:
- Li-Cher Loh
Professor of Medicine & Head
Department of Medicine
Penang Medical College, 4 Jalan Sepoy Lines
Penang, 10450 Malaysia
Tel: 604 226 3459
Fax: 604 227 6529
E-mail: [email protected] edu.my
Received date: August 08, 2011; Accepted date: November 06, 2011; Published date: November 08, 2011
Citation: Loh LC, Selvarajah N, Mohan S, Choo WS, Omar I (2011) Undiagnosed COPD in Patients with Established Cardiovascular Diseases: Prevalence, Symptoms Profiling and Functional Status. J Pulmonar Respirat Med 1:107. doi: 10.4172/2161-105X.1000107
Copyright: © 2011 Loh LC, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Background: COPD is associated with cardiovascular co-morbidities. We examined the prevalence of undiagnosed COPD in our local population of patients with stable cardiovascular diseases and the profile of their respiratory symptoms and functional status.
Methods: Eligible patients with established stable cardiovascular diseases were prospectively recruited from the cardiology outpatient clinic of an urban-based university teaching hospital and evaluated with pre- and post- bronchodilator spirometry testing and interview using standard questionnaire.
Results: Of the 501 subjects recruited, 113 (22.6%) had COPD defined on post-bronchodilator fixed FEV 1 /FVC ratio <70%. 109 (96.5%) had moderate severity while only 4 (3.5%) had severe disease by GOLD classification. Compared to non-COPD, proportionately more COPD patients were older, males, exposed to cigarette smoking (including passive smoking) and had congestive cardiac failure and pulmonary hypertension. Also proportionately more COPD subjects had more cough, sputum and dyspnoae, and poorer scores in MRC dyspnoae scale, NYHA functional class and SGRQ quality of life. These symptoms were generally worst in the evening. They also had significantly higher mean number of unscheduled visits to outpatient clinics, emergency departments and of hospital admissions over the past 12 months. After multivariate analysis, only dyspnoae [odd ratio (95%CI): 4.2 (1.8-9.7); p=0.001] and cigarette smoking [2.8 (1.1-6.80); 0.018] remained independently associated with COPD.
Conclusions: A significant proportion of patients with established cardiovascular diseases have undiagnosed COPD of moderate severity. Dyspnoae and cigarette smoking appear highly predictive of COPD.