Lay Abstract:
It is increasingly recognized that chronic obstructive pulmonary disease (COPD) is associated
with major adverse cardiovascular (CV) events, especially during periods of acute
exacerbations (COPD flare ups). This extends to non-fatal CV events such as acute coronary
syndrome, heart failure and arrhythmia, with cardiovascular disease (CVD) being one of the
leading causes of death in patients with COPD. In practice, little is known about how to
assess CV risk in COPD and thus prevent CV events. Most major CVD consensus guidelines
do not even list COPD as an important risk factor for CVD. Although some CVD risk
prediction tools include selected chronic inflammatory conditions such as rheumatoid arthritis,
they do not account for COPD in this high-risk group. Existing CVD risk prediction tools
indicate that even when CV risk is assessed, its magnitude is underestimated. Our goal is to
develop a new risk prediction tool that will help identify the patients at highest risk for CVD.
The study proposes to develop a risk prediction tool using the data from a large UK
population of patients from family medicine clinics, then validate and test its accuracy in
another similar UK population of volunteers. Lastly, the study will test the risk prediction in a
Canadian population sample where there is a large proportion who have mild, moderate and
severe exacerbations and COPD, and many not be diagnosed by their physicians. Predicting
CVD risk could be of great significance for disease management of COPD, including timely
intervention and rational drug use. We have to move away from a single disease approach
integrating care model where COPD is considered a multimorbid disease state and address in
practice the wider perspective on risk factors to improve CV sequel of COPD and healthy
longevity.
