title: COPD in patients with stable heart failure in the primary care setting.
abstract: BACKGROUND
  Presence of chronic obstructive pulmonary disease (COPD) in heart failure (HF) has prognostic and therapeutic implications. Exact prevalence estimates are lacking because most previous studies estimated the prevalence of COPD among HF patients while unstable and in the presence of pulmonary congestion.
  
  
  METHODS
  Community-dwelling patients with an established diagnosis of HF and in a stable phase of their disease were invited for spirometry. COPD was defined according to the Global initiative for chronic Obstructive Lung Disease (GOLD) classification and considered present if the ratio of the post-bronchodilator forced expiratory volume in 1 second and forced vital capacity was below 0.7.
  
  
  RESULTS
  Thirty of the 106 patients with HF (mean age 76 [standard deviation] 11.9 years, 57% male) had COPD (prevalence 28.3% [95% confidence interval (CI) 19.7%-36.9%]), with similar rates among those with HF and a reduced ejection fraction (18 individuals; prevalence 28.6% [95% CI 20.0%-37.2%]) and HF with preserved ejection fraction (12 individuals; prevalence 27.9% [95% CI 19.4-36.4]). Twenty-one (70%) of the 30 participants were newly detected cases of COPD.
  
  
  CONCLUSIONS
  More than a quarter of the patients with HF concomitantly have COPD, with the large majority being previously unrecognized. Coexistence of COPD should be considered more often in these patients.
authors.affiliation: Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Amersfoort, the Netherlands.
authors.forename: Mark J
authors.initials: MJ
authors.lastname: Valk
authors.affiliation: Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Amersfoort, the Netherlands.
authors.forename: Berna D
authors.initials: BD
authors.lastname: Broekhuizen
authors.affiliation: Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Amersfoort, the Netherlands ; Department of Cardiology, Meander Medical Center, Amersfoort, the Netherlands.
authors.forename: Arend
authors.initials: A
authors.lastname: Mosterd
authors.affiliation: Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Amersfoort, the Netherlands.
authors.forename: Nicolaas P
authors.initials: NP
authors.lastname: Zuithoff
authors.affiliation: Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Amersfoort, the Netherlands.
authors.forename: Arno W
authors.initials: AW
authors.lastname: Hoes
authors.affiliation: Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Amersfoort, the Netherlands.
authors.forename: Frans H
authors.initials: FH
authors.lastname: Rutten
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D005541:Forced Expiratory Volume; D006333:Heart Failure / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D006801:Humans; D008168:Lung / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D015995:Prevalence; D011320:Primary Health Care; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D013147:Spirometry; D013318:Stroke Volume; D014797:Vital Capacity
keywords: COPD; comorbidity; diagnosis; heart failure; prevalence; primary care; spirometry