Prevalence of Comorbidities in Patients with Chronic Obstructive Pulmonary Disease

Abstract

Background: Chronic obstructive pulmonary disease (COPD) is associated with many comorbidities, but the percentage of COPD patients who develop comorbidities has not been clearly defined. Objectives: We aimed to examine the relationship between COPD and comorbidities using information obtained from the Health Search Database (HSD) owned by the Italian College of General Practitioners (SIMG), which stores information on about 1.5% of the total Italian population served by general practitioners. Methods: We conducted a population-based retrospective study using information obtained from the HSD. The software system used codes all the diagnostic records using the 9th Revision of the International Classification of Diseases. Results: Compared to the non-COPD people, COPD patients were at increased risk for cardiovascular events [ischemic heart disease (6.9% in the general population vs. 13.6% in COPD patients), cardiac arrhythmia (6.6% in the general population vs. 15.9% in COPD patients), heart failure (2.0% in the general population vs. 7.9% in COPD patients), and other forms of heart disease (10.7% in the general population vs. 23.1% in COPD patients); with a higher impact of COPD in the elderly]; non-psychotic mental disorders, including depressive disorders (29.1% in the general population vs. 41.6% in COPD patients; with a higher impact of COPD on women aged <75 years); diabetes mellitus (10.5% in the general population vs. 18.7% in COPD patients); osteoporosis (10.8% in the general population vs. 14.8% in COPD patients), with a higher impact of COPD on women aged <75 years, and malignant pulmonary neoplasms (0.4% in the general population vs. 1.9% in COPD patients). Conclusions: Our results indicate that COPD is a risk factor for these comorbid conditions.

Asthma and comorbid medical illness

“…We believe that the most important finding of the present study is that asthma is only weakly associated with cardiovascular and hypertensive diseases, contrary to what is observed in patients with COPD [22]. This might question the importance of the systemic inflammation in asthma, as recent studies have suggested a connection between comorbidities and systemic inflammation in COPD [2][3][4].…”

Comorbidities of COPD

“…The prevalence of diabetes in COPD patients varies between studies: 10.3% in a population of grade 2/3 COPD patients in a rehabilitation centre according to CRISAFULLI et al [4], 12.6-14.5% in an all-stage COPD population according to MANNINO et al [110], 12.2% with an increased risk in active smokers according to FEARY et al [111] and 18.7% according to CAZZOLA et al [112]. The prevalence of metabolic syndrome is 22.5% for all grades according to GHANASSIA et al [113], and 53% for GOLD grade 2 COPD, 37% for GOLD grade 3 COPD and 44% for GOLD grade 4 COPD according to WATZ et al [114].…”

Physical activity, nutritional status and systemic inflammation in COPD

“…The systemic consequences that may be related to systemic inflammation include: cardiovascular disease, obesity, hypertension, type 2 diabetes, depression, deconditioning, malnutrition, atrophy and dysfunction of skeletal muscles, physical inactivity, osteoporosis, and anaemia and bone marrow dysfunction [8][9][10][11][12][13][14][15][16][17][18][19][20]. In the last decade, the relationship of comorbidities with systemic inflammation in COPD has been extensively investigated.…”