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COPD linked to increased risk of sudden cardiac death

Risk evident in general population, and increases with severity of disease

Caroline White

Wednesday, 29 April 2015

People with chronic obstructive pulmonary disease (COPD), are at increased risk of sudden cardiac death, suggests research* published online today in the European Heart Journal.

Compared with people of the same age and sex without the disease, those with COPD have a 34% increased risk of sudden cardiac death, overall. But their risk almost doubles more than five years after first being diagnosed with COPD.

Among those with frequent bouts of sudden worsening of symptoms, such as shortness of breath and cough, the risk more than triples after five years, the findings indicate.

The researchers base their findings on 13,471 people aged 45 and older taking part in the Rotterdam Study, which started in 1990 in The Netherlands, and has been monitoring almost 15,000 people, aged 45 and older, for up to 24 years.

Some 1,615 participants were diagnosed with COPD. Of the 5,197 (39%) who died, 551 did so as a result of sudden cardiac death during the monitoring period, and of these, 82 (15%) had COPD and 469 (85%) did not. People with COPD who died due to sudden cardiac death were more likely to die during the night.

The findings should help doctors to assess their patients’ risk of sudden cardiac death more accurately, as well as suggesting directions for further research into how to target prevention more effectively for patients with COPD, say the researchers.

Preventive treatments could include beta-blockers, implantable cardioverter defibrillators (ICD) to regulate heartbeat, or the withdrawal of drugs that prolong the interval between the two waves (Q and T) of the heart’s electrical cycle, such as adrenaline, various cold remedies, some antibiotics and antidepressants.

“Sudden cardiac death (SCD) is a major health problem; however, risk stratification remains difficult and probably not all risk indicators have been identified,” write the researchers.

“Chronic obstructive pulmonary disease (COPD) has been associated with an increased risk of cardiovascular disease and with SCD in specific high-risk patient populations.

“This study shows that COPD is a risk indicator for SCD in the general population and that the risk increases with COPD severity. This provides directions for further measures to prevent SCD,” they add.

* Lies Lahousse, et al. Chronic obstructive pulmonary disease and sudden cardiac death: the Rotterdam study. European Heart Journal, first published online: 28 April 2015. Doi: http://dx.doi.org/10.1093/eurheartj/ehv121.

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