In Patients with Mild-to-Moderate COPD, Tobacco Smoking, and Not COPD, Is Associated with a Higher Risk of Cardiovascular Comorbidity

• Published in: International journal of chronic obstructive pulmonary disease 2020-01, Vol.15, p.1545-1555
• Main Authors: Soumagne, Thibaud, Guillien, Alicia, Roche, Nicolas, Annesi-Maesano, Isabella, Andujar, Pascal, Laurent, Lucie, Jouneau, Stéphane, Botebol, Martial, Laplante, Jean-Jacques, Dalphin, Jean-Charles, Degano, Bruno
• Format: Article
• Language: English
• Subjects: Cancer; Cardiac arrhythmia; Cardiovascular disease; Cardiovascular diseases; Care and treatment; Cerebrovascular disease; Chronic obstructive pulmonary disease; Comorbidity; Connective tissue diseases; Coronary vessels; Dairy farms; Diabetes; diabetes mellitus; Dust; Farmers; Heart failure; Hypertension; Kidney diseases; Leukemia; Life Sciences; Liver diseases; Lung diseases; Lymphoma; Medical screening; Mortality; Organic farming; Original Research; Pharmaceutical industry; Risk factors; Smoking; Spirometry; Tobacco; tobacco smoking; Variables; Vein & artery diseases
• ISSN: 1178-2005; 1176-9106; 1178-2005
• DOI: 10.2147/COPD.S253417

Background: Comorbidities including cardiovascular diseases are very common in chronic obstructive pulmonary disease (COPD) secondary to tobacco smoking and contribute to the overall severity of the disease. In non-smoking COPD, which accounts for about 25% of COPD cases worldwide, current knowledge on the frequency and determinants of comorbidities remains scarce. The aims of the current study were to assess the frequency of major comorbidities and to evaluate their determinants in a group of non-selected patients with mild-to-moderate COPD who were exposed to organic dust (dairy farmers), to tobacco smoking, or to both, and in controls without COPD who were exposed to organic dust (dairy farmers), or to tobacco smoking, or to both, or who were without exposure. Patients and Methods: A total of 4665 subjects (2323 dairy farmers and 2342 nonfarmers) including 355 patients with COPD and 4310 controls with normal spirometry were recruited through a large COPD screening program. Self-reported physiciandiagnosed diseases with plausible links to COPD were recorded in this cross-sectional study. Results: Whatever the exposure, cardiovascular comorbidities were not more frequent in patients with COPD than their counterparts without airflow limitation. A higher risk of major cardiovascular comorbidities was associated with tobacco smoking and a lower risk was associated with exposure to organic dusts. Conclusion: Tobacco smoking (but not COPD) is associated with higher frequency of cardiovascular comorbidities. By contrast, being a dairy farmer exposed to organic dusts is associated with a lower frequency of the same comorbidities. This reinforces the crucial need for controlling established cardiovascular risk factors even in patients with mild-to-moderate COPD. Keywords: cardiovascular diseases, chronic obstructive pulmonary disease, comorbidity, diabetes mellitus, tobacco smoking