Complex coexistence of COPD and cardiovascular disease

Cardiovascular disease (CVD) and chronic obstructive pulmonary disease (COPD) are two of the leading causes of morbidity and mortality worldwide, ranking first and third, respectively, among causes of death.1 These two diseases are linked by an important modifiable risk factor: smoking. Data from previous studies indicate that the prevalence of COPD among patients with CVD ranges from 7% to 28%.1 Notably, COPD in patients with CVD has historically been underdiagnosed. In 2009, Soriano et al demonstrated that the prevalence of airflow limitation ranged from 60% in patients with CVD to 87% in those hospitalised with coronary artery disease.2 Supporting this, another study found that among smokers or former smokers hospitalised for acute coronary syndrome and undergoing spirometry, the diagnosis of COPD reached 29%.3 Cho et al analysed a large retrospective, population-based study involving 496 056 patients with a history of CVD (encompassing not only ischaemic heart disease and heart failure but also stroke). In this real-world population, only 16% had a diagnosis of COPD.4 The authors noted that COPD diagnoses were determined by evidence of COPD-related hospital admissions and/or at least three outpatient visits for COPD within 2 years.4 Although this definition is limited by not …