Frequency of occurrence of risk factors of cardiovascular diseases and assessment of the total cardiovascular risk in patients with chronic obstructive pulmonary disease (COPD)

Introduction: Cardiovascular diseases are diagnosed in more than half of patients and aggravate the course of COPD. Objective: To assess the frequency of risk factors of cardiovascular disease and the degree of total cardiovascular risk in patients with COPD. Materials and Methods: 518 patients were under supervision, 122 of them (with mild and moderate СOPD (GOLD, 2018) were included in the final analysis, satisfying the inclusion criteria: the absence of clinical manifestations of cardiovascular disease, MI and stroke history, DM. The European SCORE scale was used to assess coronary risk. Results: Low total cardiovascular risk was diagnosed in 15 (12%), medium – in 29 (24%), high – in 41 (34%), very high risk by SCORE – in 37 (30%) COPD patients. A regression analysis revealed correlation between the risk of COPD exacerbations (mMRC or CAT, severity according to spirometry) and the total cardiovascular risk of SCORE (r = 0.58; p = 0.001), as well as between the comorbidity index by M. Charlson et al. (1987) and risk by SCORE (r = 0.61; p = 0.006). The relationship between BMI and cholesterol in the study was J-shaped. The effect of inhalation therapy on the occurrence of the first manifestation of CVD was not established by Cox regression. Conclusion: in 75% of patients with COPD, an increased 10-year risk of all fatal complications of atherosclerosis is determined. The study indicates the need to assess the risk by SCORE in patients with initial manifestations of COPD in order to timely correction of the identified risk factors for cardiovascular disease.