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Systolic blood pressure, chronic obstructive pulmonary disease and cardiovascular risk

Lookup NU author(s): Dr Dexter CanoyORCiD

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This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).


Abstract

© 2023 Author(s) (or their employer(s)). Objective: In individuals with complex underlying health problems, the association between systolic blood pressure (SBP) and cardiovascular disease is less well recognised. The association between SBP and risk of cardiovascular events in patients with chronic obstructive pulmonary disease (COPD) was investigated. Methods: and analysis In this cohort study, 39 602 individuals with a diagnosis of COPD aged 55-90 years between 1990 and 2009 were identified from validated electronic health records (EHR) in the UK. The association between SBP and risk of cardiovascular end points (composite of ischaemic heart disease, heart failure, stroke and cardiovascular death) was analysed using a deep learning approach. Results: In the selected cohort (46.5% women, median age 69 years), 10 987 cardiovascular events were observed over a median follow-up period of 3.9 years. The association between SBP and risk of cardiovascular end points was found to be monotonic; the lowest SBP exposure group of <120 mm Hg presented nadir of risk. With respect to reference SBP (between 120 and 129 mm Hg), adjusted risk ratios for the primary outcome were 0.99 (95% CI 0.93 to 1.05) for SBP of <120 mm Hg, 1.02 (0.97 to 1.07) for SBP between 130 and 139 mm Hg, 1.07 (1.01 to 1.12) for SBP between 140 and 149 mm Hg, 1.11 (1.05 to 1.17) for SBP between 150 and 159 mm Hg and 1.16 (1.10 to 1.22) for SBP ≥160 mm Hg. Conclusion: Using deep learning for modelling EHR, we identified a monotonic association between SBP and risk of cardiovascular events in patients with COPD.


Publication metadata

Author(s): Rao S, Nazarzadeh M, Li Y, Canoy D, Mamouei M, Salimi-Khorshidi G, Rahimi K

Publication type: Article

Publication status: Published

Journal: Heart

Year: 2023

Volume: 109

Issue: 16

Pages: 1216-1222

Print publication date: 01/08/2023

Online publication date: 20/04/2023

Acceptance date: 04/04/2023

Date deposited: 01/03/2024

ISSN (print): 1355-6037

ISSN (electronic): 1468-201X

Publisher: BMJ Publishing Group

URL: https://doi.org/10.1136/heartjnl-2023-322431

DOI: 10.1136/heartjnl-2023-322431

Data Access Statement: Data may be obtained from a third party and are not publicly available. More details of the data and data sharing is found on the CPRD website (https://www.cprd.com). Targeted-BEHRT source code can be found on the Deep Medicine GitHub site (https://github.com/deepmedicine/Targeted-BEHRT). Example code for conducting an observational study on mock data and estimating risk ratio can also be found in this code repository.

PubMed id: 37080767


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