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      Chronic obstructive pulmonary disease as a cardiovascular risk factor: results of a case-control study (CONSISTE study)

      International Journal of Chronic Obstructive Pulmonary Disease

      Dove Medical Press

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          Abstract

          To the editor I read with interest the article “Chronic obstructive pulmonary disease as a cardiovascular risk factor. Results of a case-control study (CONSISTE study)” by de Lucas-Ramos et al.1 In my opinion, the study did not use case-control design, despite its title. The study participants were not selected on the basis of the outcome of interest, ie, cardiovascular disease (CVD), as is done in typical case-control studies. Rather, the study participants were selected according to the main exposure of interest which is presence or absence of diagnosis of chronic obstructive pulmonary disease with the CVD outcome of interest measured at a later point in time, thereby making it a retrospective cohort study. The authors even went further to state that “all patients had had a previous follow-up of more than 1 year.”1 Follow-up time is a feature of cohort study and neither case-control nor cross-sectional study.

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          Chronic obstructive pulmonary disease as a cardiovascular risk factor. Results of a case–control study (CONSISTE study)

          Introduction Chronic obstructive pulmonary disease (COPD) patients present a high prevalence of cardiovascular disease. This excess of comorbidity could be related to a common pathogenic mechanism, but it could also be explained by the existence of common risk factors. The objective of this study was to determine whether COPD patients present greater cardiovascular comorbidity than control subjects and whether COPD can be considered a risk factor per se. Methods 1200 COPD patients and 300 control subjects were recruited for this multicenter, cross-sectional, case–control study. Results Compared with the control group, the COPD group showed a significantly higher prevalence of ischemic heart disease (12.5% versus 4.7%; P < 0.0001), cerebrovascular disease (10% versus 2%; P < 0.0001), and peripheral vascular disease (16.4% versus 4.1%; P < 0.001). In the univariate risk analysis, COPD, hypertension, diabetes, obesity, and dyslipidemia were risk factors for ischemic heart disease. In the multivariate analysis adjusted for the remaining factors, COPD was still an independent risk factor (odds ratio: 2.23; 95% confidence interval: 1.18–4.24; P = 0.014). Conclusion COPD patients show a high prevalence of cardiovascular disease, higher than expected given their age and the coexistence of classic cardiovascular risk factors.
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            Author and article information

            Journal
            Int J Chron Obstruct Pulmon Dis
            Int J Chron Obstruct Pulmon Dis
            International Journal of COPD
            International Journal of Chronic Obstructive Pulmonary Disease
            Dove Medical Press
            1176-9106
            1178-2005
            2013
            2013
            21 February 2013
            : 8
            : 105-106
            Affiliations
            Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, USA
            [1 ]Respiratory Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain
            [2 ]Pneumology Department, Hospital Universitario de Guadalajara, Guadalajara, Spain
            Author notes
            Correspondence: Michael Falola, Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, USA, Email mykefalola@ 123456gmail.com
            Correspondence: Pilar de Lucas Ramos, Pneumology Department, Hospital General Universitario, Gregorio Marañon, C/Dr Esquerdo 46, 28007 Madrid, Spain, Email plucasr.hgugm@ 123456salud.madrid.org
            Article
            copd-8-105
            10.2147/COPD.S40706
            3583436
            23460764
            © 2013 Falola, publisher and licensee Dove Medical Press Ltd.

            This is an Open Access article which permits unrestricted noncommercial use, provided the original work is properly cited.

            Categories
            Letter

            Respiratory medicine

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