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Original Research: COPD |

High Prevalence of Undiagnosed Airflow Limitation in Patients With Cardiovascular Disease

Joan B. Soriano, MD; Fernando Rigo, MD; Dolores Guerrero, BSc; Aina Yañez, PhD; Josep F. Forteza, MD; Guillem Frontera, MD; Bernat Togores, MD; Alvar Agustí, MD
Author and Funding Information

From the Fundació Caubet-CIMERA Illes Balears (Drs Soriano, Yañez, Togores, Agustí, and Ms Guerrero), CIMERA, Bunyola; CIBER de Enfermedades Respiratorias (CIBERES) (Drs Soriano, Togores, and Agustí); Centro de Salud San Agustín (Dr Rigo), Palma de Mallorca; Primary Care Research redIAPP (Drs Rigo and Frontera), Mallorca; and Departments of Cardiology (Dr Forteza), Methodology (Dr Frontera), and Respiratory (Drs Togores and Agustí), Hospital Universitari Son Dureta, Palma de Mallorca, Spain.

Correspondence to: Joan B. Soriano, MD, Program of Epidemiology and Clinical Research, CIMERA, Recinte Hospital Joan March, Carretera Soller Km 12, 07110 - Bunyola, Spain; e-mail: jbsoriano@caubet-cimera.es


Dr Agustí is currently at the Institut Clínic del Tòrax, Hospital Clínic, Universitat de Barcelona (Barcelona, Spain).

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (www.chestjournal.org/site/misc/reprints.xhtml).

Funding/Support: This study was supported by research grants [FIS PI061228 for 2007-2009], redIAPP Grupo cardiovascular de Baleares [RD06/0018/0045] from the Instituto de Salud Carlos III, and by a generous donation from Fundación Barceló (www.fundacionbarcelo.org).


© 2010 American College of Chest Physicians


Chest. 2010;137(2):333-340. doi:10.1378/chest.09-1264
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Background:  The prevalence of airflow limitation (AL) in patients with cardiovascular disease (CVD) is unknown, and whether AL is adequately diagnosed and treated in these patients has not been investigated before, to our knowledge.

Methods:  We compared clinical and spirometric data in three groups of individuals. Two of them were participants in the follow-up of an ongoing population-based study according to the presence or absence of CVD. The third group included patients with coronary artery disease (CAD) confirmed by coronariography regularly visited at a tertiary referral university hospital. AL was defined according to the Global Initiative for Obstructive Lung Disease guidelines.

Results:  We studied 450 population participants without CVD, 52 population participants with CVD, and 119 hospital patients with CAD. The prevalence of AL in these three groups was 17.5% (95% CI, 14.0-21.0), 19.2% (95% CI, 8.1-30.7), and 33.6% (95% CI, 25.0-42.2), respectively (P < .05). Underdiagnosis of AL ranged from 60% in population participants with CVD up to 87.2% in hospital patients with CAD. Sixty percent of those with spirometrically confirmed AL (in all three groups) did not receive any respiratory treatment.

Conclusions:  AL is frequent in individuals with CVD, particularly in those with CAD attended in the hospital, is largely underdiagnosed and therefore is highly undertreated.

Trial registration:  Clinicaltrials.gov; Identifier: NCT00787748.

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