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Bulgaria has relatively high percentages of (very) severe COPD patients, resulting in considerable socio-economic burden. High smoking rates, occupational risk factors, air pollution, and a differential health system may be related to this finding. Eastern-European COPD strategies should focus on prevention, risk-factor awareness, and early detection.

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Chronic obstructive pulmonary disease (COPD) is a major cause of morbidity and mortality worldwide. It is also associated with significant concomitant diseases which affect the disease progression course, and contribute to the exacerbation of health status and overall mortality rate. The aim of this study was to identify the most frequent Cardio-vascular disease (CVD) comorbidities among patients with COPD in Bulgaria and their effect on the hospitalization rate, hospital stay duration and health status. A retrospective national observational study was conducted among a statistically representative cohort of 426 patients in Bulgaria. Demographic data, smoking, clinical data for COPD severity and co-morbidity were collected. Health status was assessed through the specific COPD assessment test (CAT). CVD co-morbidity was evaluated by type, considering the GOLD guidelines and number. More than 80% of the patients reported two and more CVD co-morbidities and all of them reported more than two exacerbations and more than two hospitalizations over the last year. The most frequently reported CVD co-morbidity was hypertension, which was present in 88% of the men and in 89% of the women. The data showed a positive correlation between the cardiovascular risk and the progression of the disease. Hypertension, ischemic heart disease and heart failure prevailed in the observed population. With the advancement of COPD, the number of CVDs diseases per patient and CAT score, average hospitalization rate and hospital stay increased.

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