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COPD in patients with stable heart failure in the primary care setting

Authors Valk M, Broekhuizen B, Mosterd A, Zuithoff NP, Hoes AW, Rutten F

Received 5 November 2014

Accepted for publication 3 February 2015

Published 26 June 2015 Volume 2015:10(1) Pages 1219—1224


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 5

Editor who approved publication: Dr Richard Russell

Mark J Valk,1 Berna D Broekhuizen,1 Arend Mosterd,1,2 Nicolaas P Zuithoff,1 Arno W Hoes,1 Frans H Rutten1

1Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, 2Department of Cardiology, Meander Medical Center, Amersfoort, the Netherlands

Background: Presence of chronic obstructive pulmonary disease (COPD) in heart failure (HF) has prognostic and therapeutic implications. Exact prevalence estimates are lacking because most previous studies estimated the prevalence of COPD among HF patients while unstable and in the presence of pulmonary congestion.
Methods: Community-dwelling patients with an established diagnosis of HF and in a stable phase of their disease were invited for spirometry. COPD was defined according to the Global initiative for chronic Obstructive Lung Disease (GOLD) classification and considered present if the ratio of the post-bronchodilator forced expiratory volume in 1 second and forced vital capacity was below 0.7.
Results: Thirty of the 106 patients with HF (mean age 76 [standard deviation] 11.9 years, 57% male) had COPD (prevalence 28.3% [95% confidence interval (CI) 19.7%–36.9%]), with similar rates among those with HF and a reduced ejection fraction (18 individuals; prevalence 28.6% [95% CI 20.0%–37.2%]) and HF with preserved ejection fraction (12 individuals; prevalence 27.9% [95% CI 19.4–36.4]). Twenty-one (70%) of the 30 participants were newly detected cases of COPD.
Conclusion: More than a quarter of the patients with HF concomitantly have COPD, with the large majority being previously unrecognized. Coexistence of COPD should be considered more often in these patients.

Keywords: heart failure, COPD, prevalence, comorbidity, spirometry, diagnosis, primary care

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