Cardiovascular

Impact of concurrent COPD and cardiovascular disease on mortality.

Lee H, Kim S, et al. • Respiratory medicine • 2026

Cohort PubMed 42203183 DOI 10.1016/j.rmed.2026.108895

TL;DR

Coexisting COPD and CVD defines a distinct high-risk phenotype with a significantly increased absolute burden of all-cause and cause-specific mortality, underscoring the need for integrated cardiopulmonary risk management.

Key Findings

Results

Participants with coexisting COPD and CVD had a markedly increased risk of all-cause mortality compared to those without either condition.

Adjusted HR for all-cause mortality was 2.207 (95% CI: 2.113–2.305)
Study population included 293,948 participants followed for a median of 12.9 years
3.9% of participants had coexisting COPD and CVD at baseline
Multivariable Cox proportional-hazards models were used to estimate adjusted HRs

Results

Risks of respiratory-specific and cardiovascular-specific mortality were substantially elevated among participants with both COPD and CVD.

Both cause-specific outcomes were assessed as secondary endpoints alongside all-cause mortality
Lung cancer mortality was also assessed as a secondary outcome
Competing-risk analyses were used in addition to standard Cox models to estimate cause-specific mortality

Results

The interaction between COPD and CVD on mortality risk was less than multiplicative on the hazard ratio scale.

Despite a sub-multiplicative statistical interaction, the absolute mortality burden was greatest among participants with both conditions
This finding suggests that relative risk metrics may understate the true population-level burden of comorbid COPD and CVD

Results

The excess absolute risk of all-cause mortality associated with coexisting COPD and CVD at 10 years was 13.9 percentage points.

The 10-year excess absolute risk was 13.9 percentage points compared to participants without either condition
This corresponded to a number needed to harm (NNH) of 7.2
Absolute risks and risk differences were calculated to quantify excess mortality burden beyond relative risk measures

Methods

The study used a population-based cohort design drawing from UK Biobank data with four disease-status groups at baseline.

Participants were classified into four groups: neither condition, COPD only, CVD only, and both COPD and CVD
The primary outcome was all-cause mortality; secondary outcomes included respiratory, cardiovascular, and lung cancer mortality
Total sample size was 293,948 with a median follow-up of 12.9 years

What This Means

This research suggests that people who have both chronic obstructive pulmonary disease (COPD) and cardiovascular disease (CVD) at the same time face a dramatically higher risk of dying than people with neither condition. Using data from nearly 300,000 UK Biobank participants followed for roughly 13 years, the study found that having both diseases together more than doubled the risk of death overall, and also significantly raised the chances of dying specifically from heart or lung-related causes. One of the study's important contributions is its focus on absolute risk — not just how much higher the relative risk is, but how many extra deaths actually occur. For every 7–8 people with both COPD and CVD, one additional death occurred within 10 years compared to people with neither condition. This kind of measure is useful for understanding real-world impact, since a condition can look less alarming when only relative risk is reported. This research suggests that people living with both COPD and CVD represent a distinct high-risk group that may benefit from more coordinated medical care addressing both heart and lung health simultaneously. The findings highlight a gap in how these overlapping conditions are currently managed and point toward the potential value of integrated cardiopulmonary treatment strategies.

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Citation

Lee H, Kim S, Rhee C, Kim D, Choi J. (2026). Impact of concurrent COPD and cardiovascular disease on mortality.. Respiratory medicine. https://doi.org/10.1016/j.rmed.2026.108895

Key Findings

What This Means

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