High prevalence of undiagnosed airflow limitation in patients with cardiovascular disease.
BACKGROUND
The prevalence of airflow limitation (AL) in patients with cardiovascular disease (CVD) is unknown, and whether AL is adequately diagnosed and treated in these patients has not been investigated before, to our knowledge.


METHODS
We compared clinical and spirometric data in three groups of individuals. Two of them were participants in the follow-up of an ongoing population-based study according to the presence or absence of CVD. The third group included patients with coronary artery disease (CAD) confirmed by coronariography regularly visited at a tertiary referral university hospital. AL was defined according to the Global Initiative for Obstructive Lung Disease guidelines.


RESULTS
We studied 450 population participants without CVD, 52 population participants with CVD, and 119 hospital patients with CAD. The prevalence of AL in these three groups was 17.5% (95% CI, 14.0-21.0), 19.2% (95% CI, 8.1-30.7), and 33.6% (95% CI, 25.0-42.2), respectively (P < .05). Underdiagnosis of AL ranged from 60% in population participants with CVD up to 87.2% in hospital patients with CAD. Sixty percent of those with spirometrically confirmed AL (in all three groups) did not receive any respiratory treatment.


CONCLUSIONS
AL is frequent in individuals with CVD, particularly in those with CAD attended in the hospital, is largely underdiagnosed and therefore is highly undertreated.


BACKGROUND
Clinicaltrials.gov; Identifier: NCT00787748.
Fundació Caubet-CIMERA Illes Balears, CIMERA, Bunyola, Spain. jbsoriano@caubet-cimera.es
Joan B
JB
Soriano
Fernando
F
Rigo
Dolores
D
Guerrero
Aina
A
Yañez
Josep F
JF
Forteza
Guillem
G
Frontera
Bernat
B
Togores
Alvar
A
Agustí
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology; D003951:Diagnostic Errors; D004417:Dyspnea / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D005541:Forced Expiratory Volume / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011379:Prognosis; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology; D012189:Retrospective Studies; D013030:Spain / Q000453:epidemiology; D013147:Spirometry