Abstract
Patients with chronic obstructive pulmonary disease (COPD) commonly present with multimorbidity. We aimed to investigate the association between COPD and the development of peripheral arterial disease (PAD) in the general population, and how this might affect mortality among individuals with COPD.
We included 3123 participants of the population-based Rotterdam Study without PAD at baseline (mean age 65 years; 57.4% female). The association between COPD at baseline and PAD during follow-up was studied using logistic regression (PAD being indicated by an ankle–brachial index (ABI) of 0.9 or less). Cox regression was used for mortality analysis and interaction terms were used to investigate mortality risk modification by PAD.
The presence of COPD was associated with incident PAD (adjusted odds ratio 1.9, 95% CI 1.1–3.2). Mortality rates per 100 000 person-years were as follows: 10.0 in individuals without COPD or PAD, 18.4 in those with COPD only, 16.1 in those with PAD only and 30.1 in individuals with both COPD and PAD. No statistical interaction was found between PAD and COPD on risk of dying.
Individuals with COPD have an almost doubled risk of developing PAD. Although PAD does not modify the association between COPD and mortality, people suffering from both diseases have substantially higher mortality rates.
Abstract
Individuals with COPD have an almost doubled risk of developing peripheral arterial disease (PAD). People suffering from both COPD and PAD have substantially higher mortality rates. http://ow.ly/IyOx30m0IBo
Footnotes
Clinical trials: The Rotterdam Study has been entered into the Netherlands National Trial Register (NTR; www.trialregister.nl) and into the WHO International Clinical Trials Registry Platform (ICTRP; www.who.int/ictrp/network/primary/en/) under shared catalogue number NTR6831.
Conflict of interest: N. Terzikhan has nothing to disclose. L. Lahousse reports personal fees (for expert consultation) from Boehringer Ingelheim GmbH and Novartis, and grants (for unrestricted research) from AstraZeneca and Chiesi, outside the submitted work.
Conflict of interest: K.M.M. Verhamme has received grants from GSK and Novartis, and works for a research group which has received unconditional research grants from Pfizer/Boehringer Ingelheim, Novartis, GSK and Yamanouchi. None of which are related to the content of this work.
Conflict of interest: O.H. Franco reports grants from Nestle (for child nutrition) and Metagenics (for womens health), outside the submitted work. A. Ikram has nothing to disclose. B.H. Stricker has nothing to disclose. G.G. Brusselle has nothing to disclose.
Support statement: This work was supported by a grant from the Fund for Scientific Research Flanders (FWO; project G035014N). The Rotterdam Study is funded by Erasmus MC and Erasmus University Rotterdam; the Netherlands Organisation for Health Research and Development (ZonMw); the Research Institute for Diseases in the Elderly (RIDE); the Ministry of Education, Culture and Science; the Ministry for Health, Welfare and Sports; the European Commission (DG XII); and the Municipality of Rotterdam. Funding information for this article has been deposited with the Crossref Funder Registry.
- Received June 12, 2018.
- Accepted September 23, 2018.
- Copyright ©ERS 2018
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