The association between cardiovascular diseases and their subcategories with the severity of chronic obstructive pulmonary disease: a large cross-sectional study based on a Chinese hospital population cohort

Background Current evidence suggests that cardiovascular disease (CVD) plays a role in the progression of chronic obstructive pulmonary disease (COPD). However, the relationship between CVD and the severity of COPD remains inadequately understood. Therefore, this study aims to elucidate the association between CVD and the severity of COPD. Methods In this cross-sectional study involving 7,152 individuals with COPD., Logistic regression, subgroup and sensitivity analyses were employed to evaluate the association between CVD, its subcategories, and the severity of COPD. Results Multivariable logistic regression analysis showed that CVD and hypertension remained independently associated with COPD severity ( P < 0.001). Patients with CVD had a 1.701 times higher risk of developing severe or very severe COPD compared to those without CVD, while patients with hypertension had a 1.686 times higher risk of developing severe or very severe COPD compared to those without hypertension ( P < 0.05). Subgroup analyses showed that the association between CVD and COPD severity remained stable among men, patients ≤ 70 years of age, patients > 70 years of age, BMI < 24 or ≥24 kg/m 2 , and never smokers, whereas coronary artery disease was significantly associated with COPD severity only among patients ≤ 70 years of age and never smokers ( P < 0.05). In addition, hypertension was also stably associated with COPD severity among men, patients ≤ 70 years of age, patients > 70 years of age, BMI < 24 or ≥24 kg/m 2 , and never smokers. Sensitivity analyses reconfirmed the robustness of the associations of CVD and hypertension with COPD severity among patients who excluded bronchiectasis, tuberculosis, lung cancer, pulmonary hypertension, pulmonary heart disease, and diabetes ( P < 0.05). Conclusion The strong association between CVD and its subcategories (mainly hypertension) and the severity of COPD suggests that the potential risk of exacerbation of CVD should also be addressed in the clinical management of patients with COPD. However, limitations of the cross-sectional design may limit the extrapolation of the results, and more large prospective clinical cohort studies are needed in the future to further validate the association.