Impact of concurrent COPD and cardiovascular disease on mortality

초록

Background: Chronic obstructive pulmonary disease (COPD) and cardiovascular disease (CVD) frequently coexist and share common risk factors. However, the mortality burden associated with their co-occurrence has not been fully characterized at the population level, particularly with respect to cause-specific and absolute risks. Methods: We conducted a population-based cohort study using data from UK Biobank. Participants were classified into four groups according to baseline COPD and CVD status. The primary outcome was all-cause mortality, and secondary outcomes included respiratory, cardiovascular, and lung cancer mortality. Multivariable Cox proportional-hazards models and competing-risk analyses were used to estimate adjusted hazard ratios (HRs). Absolute risks, risk differences, and numbers needed to harm (NNH) were calculated to quantify excess mortality burden. Results: Among 293,948 participants followed for a median of 12.9 years, 3.9% had coexisting COPD and CVD at baseline. Compared to participants without either condition, those with both had a markedly increased risk of all-cause mortality (adjusted HR, 2.207 [95% confidence interval, 2.113–2.305]). Risks of respiratory-specific and cardiovascular-specific mortality were also substantially elevated. Although the COPD/CVD interaction was less than multiplicative on the HR scale, the absolute mortality burden was greatest among participants with both conditions. At 10 years, the excess absolute risk of all-cause mortality associated with coexisting COPD and CVD was 13.9 percentage points, corresponding to an NNH of 7.2. Conclusion: Coexisting COPD and CVD defines a distinct high-risk phenotype with a significantly increased absolute burden of all-cause and cause-specific mortality, underscoring the need for integrated cardiopulmonary risk management. © 2026 Elsevier Ltd. All rights are reserved, including those for text and data mining, AI training, and similar technologies.

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