Chronic obstructive pulmonary disease as a risk factor for cardiovascular morbidity and mortality.
Chronic obstructive pulmonary disease as a risk factor for cardiovascular morbidity and mortality.
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DOI：
10.1513/pats.200404-032ms
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发表时间：
2005-01-01
期刊：
影响因子：
--
通讯作者：
Man, S F Paul
中科院分区：
文献类型：
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作者：
Sin, Don D;Man, S F Paul
慢性阻塞性肺疾病和其他与肺功能降低相关的疾病是心血管事件的强风险因素，与吸烟无关。总的来说，当肺功能最低的五分之一（以FEV1测量）与最高的五分之一相比时，男性和女性的心血管死亡风险增加约75%。有慢性支气管炎的症状，单独增加了50%的冠心病死亡的风险。FEV1与FVC比值降低本身是冠状动脉事件的一个中度独立风险因素，可使风险增加30%。然而，如果患者有室性心律失常，冠状动脉事件的风险增加两倍，这表明阻塞性气道疾病的心脏毒性作用在那些有潜在心律失常的人中被放大。一般来说，FEV1每减少10%，全因死亡率增加14%，心血管死亡率增加28%，非致命性冠状动脉事件增加近20%。这些数据表明，慢性阻塞性肺疾病是心血管疾病发病率和死亡率的一个强有力的独立危险因素。
Chronic obstructive pulmonary disease and other disorders, associated with reduced lung function, are strong risk factors for cardiovascular events, independent of smoking. Overall, when the lowest quintile of lung function, as measured by FEV1 is compared with the highest quintile, the risk of cardiovascular mortality increases by approximately 75% in both men and women. Having symptoms of chronic bronchitis alone increases the risk of coronary deaths by 50%. Reduced ratio of FEV1 to FVC by itself is a modest independent risk factor for coronary events, increasing the risk by 30%. However, if patients have ventricular arrhythmias, the risk of coronary events is increased twofold, suggesting that the cardiotoxic effects of obstructive airways disease are amplified in those who have underlying cardiac rhythm disturbances. In general, for every 10% decrease in FEV1, all-cause mortality increases by 14%, cardiovascular mortality increases by 28%, and nonfatal coronary event increases by almost 20%. These data indicate that chronic obstructive pulmonary disease is a powerful, independent risk factor for cardiovascular morbidity and mortality.