Chronic obstructive pulmonary disease and cardiovascular mortality in elderly subjects from general population.
OBJECTIVE
To ascertain whether chronic obstructive pulmonary disease (COPD) is an independent risk factor for cardiovascular (CV) mortality in the elderly subjects from general population.


METHODS
3282 subjects of the Northern Italy aged > or =65 years were followed up for 12 years in the frame of the CArdiovascular STtudy in the ELderly. Multivariate stepwise proportional hazard Cox regression was therefore used to identify the prognostic role of COPD on CV mortality in hypertensive (HT) and normotensive (NT) subjects. The hazard ratio (HR) of COPD with 95% confidence interval (CI) for mortality was adjusted for confounders in both genders.


RESULTS
COPD resulted to be an independent predictor of CV mortality (HR 1.34, CI 1.13-1.61) in HT but not in NT subjects. This was evident both in men (HR 1.44, 1.25-1.95) and women (HR 1.32, CI 1.14-1.53); pulse pressure (PP) was directly related and anti-hypertensive therapy inversely related to risk of CV mortality, an association that was greater in subjects with than without COPD.


CONCLUSIONS
COPD should be included in the computation of global risk in HT subjects. PP is the main BP component in increasing CV risk in subjects with COPD. Controlled trials should be performed to evaluate the pressor targets to be reached in HT subjects with COPD, with the aim of decreasing their CV risk.
Mazza
Alberto
A
Department of Internal Medicine, General Hospital of Rovigo, Italy. mazza.alberto@azisanrovigo.it
Zamboni
Sergio
S
Rubello
Domenico
D
Schiavon
Laura
L
Zorzan
Sara
S
Casiglia
Edoardo
E
D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use; D002318:Cardiovascular Diseases / Q000188:drug therapy / Q000401:mortality*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy / Q000401:mortality / Q000503:physiopathology; D008297:Male; D011379:Prognosis; D029424:Pulmonary Disease, Chronic Obstructive / Q000188:drug therapy / Q000401:mortality*; D012307:Risk Factors
D000959:Antihypertensive Agents