Increased odds of cardiovascular and premature death encountered among COPD and Asthma patients

Finland: A new research found that increased mortality due to cardiovascular disease and premature death has been found in patients with asthma and chronic obstructive pulmonary disease patients. The study results were published in the journal Respiratory Medicine. 

Asthma and chronic obstructive pulmonary disease (COPD) are globally underdiagnosed, obstructive airway diseases with different pathophysiology and patient characteristics that caused increased morbidity and mortality. The mortality in asthma is dependent on factors like smoking status, lung function, and exacerbations, and other comorbidities while the mortality in COPD is due to the severity of obstruction, decreased forced expiratory volume per 1 s, systemic inflammation. Tiina Matilla et al from Helsinki, Finland conducted a study to understand the comorbidities of asthma, COPD, and asthma-COPD overlap (ACO) and reported the total and cause-specific mortality over an 18-year follow-up. 

A national health examination survey was carried out on Finnish adults aged ≥30 years in 2000–2001. Nearly 5922 participants (73.8% of the sample) with all relevant data, including a comprehensive clinical examination and spirometry, were included in the study cohort. The total, cardiovascular, cancer, and respiratory mortality were recorded through a record linkage by following the patients from baseline until the end of 2018. Survey data, including spirometry and register data, were used to define asthma, COPD, and ACO. There were three separate groups of obstructive subjects (one definition excluding the others).  

Key findings of the study: 

• In Cox's model adjusted for sex, age, smoking, education level, BMI, leisure time physical activity, cardiovascular disease, diabetes, and hypertension it was found that asthma and COPD were significantly associated with higher total mortality. 
• Hazard ratios (HR) for asthma, COPD, and ACO were 1.29, 1.50, and 1.26 respectively.
• Asthma and COPD were associated with cardiovascular mortality.
• There was a significant association with mortality risk among those with hs-CRP 1–2.99 mg/l even though ACO did not predict mortality in the whole cohort. 

Thus, this Finnish national health survey found that having asthma or COPD at baseline predicted mortality especially due to cardiovascular diseases during an 18-year follow-up. 

Further reading: Mattila T, Vasankari T, Kauppi P, Mazur W, Härkänen T, Heliövaara M. Mortality of asthma, COPD, and asthma-COPD overlap during an 18-year follow up [published online ahead of print, 2022 Dec 31]. Respir Med. 2022;107112. doi: 10.1016/j.rmed.2022.107112