Impact of non-cardiovascular disease comorbidity on cardiovascular disease symptom severity: a population-based study.
Impact of non-cardiovascular disease comorbidity on cardiovascular disease symptom severity: a population-based study.
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DOI：
10.1016/j.ijcard.2014.05.001
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发表时间：
2014-07-15
影响因子：
3.5
通讯作者：
Kadam, U. T.
中科院分区：
文献类型：
--
作者：
Rushton, C. A.;Kadam, U. T.
非心血管合并症在心血管疾病 (CVD) 人群中很常见，但其对胸痛 (CP) 和呼吸短促 (SOB) 症状特异性身体限制的影响尚不清楚。我们想要检验先验假设，即不相关的合并症会影响特定症状的身体限制，并研究不同严重程度的 CVD 的这种影响。该研究以来自 10 个家庭诊所的 5426 名患者为基础，分为八个预先确定的严重程度组：(i) 无 CVD 或骨关节炎 (OA)（参考），(ii) 指数高血压、缺血性心脏病 (IHD) 和心力衰竭 (HF)，无 OA，(iii) 指数 OA，无 CVD 和 (iv) 具有共病 OA 的相同 CVD 组。 CP 身体限制的衡量标准是西雅图心绞痛问卷，SOB 身体限制的衡量标准是堪萨斯城心肌病问卷。使用线性回归方法评估队列和特定症状身体限制之间调整后的基线关联。在研究人群中，1443 人（27%）报告有 CP，2097 人（39%）报告有 SOB。在指数组和共病组中，CP 和 SOB 身体限制随着 CVD 的严重程度而增加。与相应的 CVD 指数组相比，合并 OA 的 CVD 组的 CP 身体限制评分较低：高血压为 − 14.7 (95% CI − 21.5, 7.8)，IHD 为 − 5.5 (− 10.4, − 0.7)，心力衰竭为 − 22.1 (− 31.0, − 6.7)。对于 SOB 身体限制，共病评分较低：高血压为 − 9.2 (− 13.8, − 4.6)，IHD 为 − 6.4 (− 11.1, − 1.8)，心力衰竭为 − 8.8 (− 19.3, 1.65)。 CP 和 SOB 是常见症状，而 OA 则进一步增加了 CVD 症状特有的身体限制。需要针对 CVD 特定的健康结果制定合并症干预措施。该研究基于英国 10 个全科诊所的 5426 名患者。先验排他性组包括患有和不患有 OA 的 CVD 严重程度指数组。 CVD 严重程度的增加和合并 OA 与 CVD 症状限制相关。 CVD 组中合并 OA 会进一步增加症状的身体限制。需要针对 CVD 特定的健康结果制定合并症干预措施。
Non-cardiovascular comorbidity is common in cardiovascular disease (CVD) populations but its influence on chest pain (CP) and shortness of breath (SOB) symptom-specific physical limitations is unknown. We wanted to test the a priori hypothesis that an unrelated comorbidity would influence symptom-specific physical limitations and to investigate this impact in different severities of CVD. The study was based on 5426 patients from ten family practices, organised into eight a priori exclusive severity groups: (i) no CVD or osteoarthritis (OA) (reference), (ii) index hypertension, ischaemic heart disease (IHD) and heart failure (HF) without OA, (iii) index OA without CVD and (iv) same CVD groups with comorbid OA. The measure of CP physical limitations was Seattle Angina Questionnaire and for SOB physical limitations was the Kansas City Cardiomyopathy Questionnaire. Adjusted baseline associations between the cohorts and symptom-specific physical limitations were assessed using linear regression methods. In the study population, 1443 (27%) reported CP and 2097 (39%) SOB. CP and SOB physical limitations increased with CVD severity in the index and comorbid groups. Compared with the respective index CVD group, the CP physical limitation scores for comorbid CVD groups with OA were lower by: − 14.7 (95% CI − 21.5, 7.8) for hypertension, − 5.5 (− 10.4, − 0.7) for IHD and − 22.1 (− 31.0, − 6.7) for HF. For SOB physical limitations, comorbid scores were lower by: − 9.2 (− 13.8, − 4.6) for hypertension, − 6.4 (− 11.1, − 1.8) for IHD and − 8.8 (− 19.3, 1.65) for HF. CP and SOB are common symptoms, and OA increases the CVD symptom-specific physical limitations additively. Comorbidity interventions need to be developed for CVD specific health outcomes. The study was based on 5426 patients from 10 general practices in the UK. A priori exclusive groups included index CVD severity groups with and without OA. Increasing CVD severity and comorbid OA are associated with CVD symptom limitation. Comorbid OA in CVD groups increases symptom physical limitations additively. Comorbidity interventions need to be developed for CVD specific health outcomes.
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