Cardiovascular disease was significantly associated with higher overall mortality (HR 1.71; 95% CI 1.47-1.99) and increased odds of COPD (OR 3.37; 95% CI 2.20-5.18) among US adults.
Cross-Sectional (n=35,162)
Are cardiovascular disease, diabetes, and hypertension associated with increased respiratory morbidity and mortality in adults?
Cardiometabolic comorbidities, particularly cardiovascular disease, are significantly associated with increased respiratory morbidity and mortality in adults with obstructive lung diseases.
Effect estimate: OR 3.37 (95% CI 2.20-5.18)
Abstract Rationale Chronic obstructive pulmonary disease (COPD) and asthma frequently coexist with cardiometabolic conditions, including cardiovascular disease (CVD), diabetes, and hypertension. However, the individual impact of these comorbidities on respiratory outcomes and mortality remains unclear. This study examined the associations between cardiometabolic comorbidities and respiratory morbidity and mortality in adults with COPD and asthma. Methods We conducted a cross-sectional analysis of 35,162 adults (representing 233.9 million United States adults) aged 18 years and older from the 2007-2018 National Health and Nutrition Examination Survey (NHANES). Participants with complete data on exposures, outcomes, and covariates for the fully adjusted World Health Organization (WHO) model were included. Primary exposures were self-reported CVD, diabetes, and hypertension. Respiratory outcomes included COPD, emphysema, chronic bronchitis, asthma, and asthma attacks. Composite categories included emphysema-chronic bronchitis-COPD (EBCOPD), emphysema-COPD (ECOPD), and asthma-COPD overlap (ACO). Overall mortality through 2019 was obtained from NHANES-linked National Death Index data. Survey-weighted logistic models estimated adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for associations between cardiometabolic conditions and respiratory outcomes. Cox proportional hazards models estimated adjusted hazard ratios (HRs) for overall mortality and each respiratory disease outcome. Analyses were adjusted for age, sex, race/ethnicity, body mass index, smoking, socioeconomic status, and physical activity (WHO Full). Results CVD was associated with significantly higher odds of COPD (OR 3.37; 95% CI, 2.20-5.18), EBCOPD (2.10; 1.64-2.69), ECOPD (2.69; 1.88-3.84), asthma (1.59; 1.34-1.89), asthma attacks (1.65; 1.17-2.32), and ACO (2.34; 1.76-3.11). CVD also predicted higher mortality in EBCOPD (aHR 1.74, 1.12-2.69) and asthma (1.49 1.01-2.18) Table 1. Diabetes was associated with increased odds of COPD (OR 1.87; 1.23-2.83), EBCOPD (1.66; 1.28-2.14), ECOPD (2.00; 1.43-2.82), asthma (1.26; 1.05-1.51), and ACO (1.64; 1.24-2.17), as well as higher mortality in asthma (HR 1.81; 1.18-2.79) and ACO (1.92; 1.03-3.59). Hypertension was associated with greater odds of EBCOPD (OR 1.24; 1.02-1.51), asthma (1.32; 1.16-1.51), and ACO (1.66; 1.31-2.10), and with higher mortality in EBCOPD (HR 1.68; 1.13-2.49), ECOPD (1.68; 1.04-2.74), asthma (1.66; 1.04-2.65), and asthma attacks (2.51; 1.02-6.15). Overall mortality was significantly higher among participants with CVD (HR 1.71;, 1.47-1.99), diabetes (1.33; 1.13-1.57), and hypertension (1.36; 1.17-1.58). Conclusion Cardiometabolic comorbidities were consistently associated with greater respiratory morbidity and mortality. The strongest association was seen with CVD, while diabetes and hypertension also contributed to adverse respiratory and survival outcomes. These findings highlight the significant cardiometabolic burden in chronic respiratory disease and the importance of integrated management strategies addressing both pulmonary and cardiovascular risk factors. This abstract is funded by: None
Fadell et al. (Fri,) conducted a cross-sectional in Cardiometabolic comorbidities and airway obstructive lung diseases (n=35,162). Cardiovascular disease, diabetes, and hypertension was evaluated on COPD (associated with CVD) (OR 3.37, 95% CI 2.20-5.18). Cardiovascular disease was significantly associated with higher overall mortality (HR 1.71; 95% CI 1.47-1.99) and increased odds of COPD (OR 3.37; 95% CI 2.20-5.18) among US adults.