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Original Research: Diffuse Lung Disease |

Risk Factors for Cardiovascular Disease in People With Idiopathic Pulmonary FibrosisRisk Factors in Idiopathic Pulmonary Fibrosis: A Population-Based Study

William Dalleywater, BMBS; Helen A. Powell, PhD; Richard B. Hubbard, MD; Vidya Navaratnam, PhD
Author and Funding Information

From the Division of Epidemiology and Public Health (Drs Dalleywater, Powell, Hubbard, and Navaratnam) and the Respiratory Research Unit (Drs Powell, Hubbard, and Navaratnam), University of Nottingham, Nottingham, England.

CORRESPONDENCE TO: Vidya Navaratnam, PhD, Division of Epidemiology and Public Health/Respiratory Research Unit, University of Nottingham, Clinical Sciences Building, Nottingham City Hospital, Hucknall Rd, Nottingham, NG5 1PB, England; e-mail: vidya.navaratnam@nottingham.ac.uk


FUNDING/SUPPORT: Dr Hubbard is the British Lung Foundation/GlaxoSmithKline professor of respiratory epidemiology. Dr Powell is funded by the National Institute for Health Research (NIHR) through the Nottingham Respiratory Research Unit. Dr Navaratnam is an NIHR-funded Academic Clinical Fellow.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.


Chest. 2015;147(1):150-156. doi:10.1378/chest.14-0041
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OBJECTIVE:  People with idiopathic pulmonary fibrosis (IPF) have been shown to be at an increased risk for cardiovascular (CV) disease, but reasons for this are unknown. The aim of this study was to compare the prevalence of common CV risk factors in people with IPF and the general population and establish the incidence of ischemic heart disease (IHD) and stroke after the diagnosis of IPF, controlling for these risk factors.

METHODS:  We used data from a large, UK primary care database to identify incident cases of IPF and matched general-population control subjects. We compared the prevalence of risk factors for CV disease and prescription of CV medications in people with IPF (before diagnosis) with control subjects from the general population and assessed the incidence of IHD and stroke in people with IPF (after diagnosis) compared with control subjects.

RESULTS:  We identified 3,211 cases of IPF and 12,307 control subjects. Patients with IPF were more likely to have a record of hypertension (OR, 1.31; 95% CI, 1.19-1.44), and diabetes (OR, 1.20; 95% CI, 1.07-1.34) compared with control subjects; they were also more likely to have been prescribed several CV drugs. The rate of first-time IHD events was more than twice as high in patients than control subjects (rate ratio, 2.32; 95% CI, 1.85-2.93; P < .001), but the incidence of stroke was only marginally higher (P = .09). Rate ratios for IHD and stroke were not altered substantially after adjusting for CV risk factors.

CONCLUSIONS:  Several CV risk factors were more prevalent in people with IPF; however, this did not account for the increased rate of IHD in this group of patients.

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