Cardiovascular comorbidities and clinical outcomes in a cohort of adults with COPD in Jos, Nigeria: A prospective analytical study

Abstract

Background: Chronic obstructive pulmonary disease (COPD) is a significant contributor to morbidity and mortality worldwide. Cardiovascular diseases (CVD) are a leading but under-recognized cause of morbidity and mortality among persons with COPD. This is concerning and highlights the need for more studies and awareness, particularly in resource-limited settings.
Methods: This prospective cohort study involved 82 eligible adults with spirometry-confirmed COPD enrolled consecutively at Jos University Teaching Hospital (JUTH). Each participant underwent a medical history review, physical examination and relevant investigations. Each was followed up for 450 days through monthly clinic visits and phone calls. Clinical outcomes (cardiopulmonary-related hospitalizations and deaths) were recorded. Data was analyzed using Epi-Info version 7.2 and Stata version 13.
Results: About 67.1% (55) had comorbid cardiovascular disease. The common CVD found were pulmonary hypertension (45.5%, 37), arrhythmias (40.0%, 33), systemic hypertension (38.2%, 31), and heart failure (30.9%, 25) among others. CVD comorbidity was significantly associated with COPD progression (p=0.047), higher 450-day hospitalization rate and duration (p=0.015 and 0.050); and mortality rate (p=0.029). Kaplan-Meier analysis showed a significant statistical difference in time to first hospitalization (p<0.085),
duration of hospitalization (p=0.013), and time to mortality (p<0.085) over 450 days in participants with CVD compared to those without, Cox proportional hazard analysis further showed that those with CVD had a risk of 253% for hospitalization and 230% for mortality over 450 days.
Conclusion: Cardiovascular comorbidities are common in patients with COPD. They are important determinants of morbidity, hospitalization and mortality. Early diagnosis and management will significantly reduce morbidity and mortality in these patients.