Incidence of heart failure, atrial fibrillation and ischaemic heart disease in patients with chronic obstructive pulmonary disease registered with a general practice within the Mid-Ulster Federation area

Introduction: Cardiovascular disease (CVD) co-morbidities are one of the most common co-morbidities of chronic obstructive pulmonary disease (COPD) and have a negative effect in terms exacerbations, hospital admissions, quality of life and mortality. CVD co-morbidities are often under-diagnosed and undertreated within the general COPD population. Research is needed to highlight the prevalence of these important co-morbidities to all healthcare professionals to improve the rate of their detection and diagnosis, thus improving management and outcomes for these patients. Method: De-identified and fully anonymised data collated from eleven GP practices within the Mid-Ulster Federation during April 2023 underwent comparator analysis and trend identification (n=77,979). Quality of Outcomes Framework (QOF) codes were used to identify patients with COPD and/or CVD. Searches were repeated for COPD patients (n=1575) during July 2023 to record patient gender, age and smoking status along with QOF register searches. Student’s T Test and Chi-square test for independence were performed as appropriate. p<0.05 were considered statistically significant. Results: This study provides population-based evidence of higher prevalence of atrial fibrillation (AF), ischaemic heart disease (IHD), and heart failure (HF) among people with COPD compared to those without COPD within the Mid-Ulster Federation area (p<0.001) (Table 1). The prevalence of AF, IHD and HF was greater in males than females (p<0.001, p<0.001 and p<0.01 respectively). The incidence of IHD and HF was not significantly different for current or ex-smokers compared to never smokers (p>0.05) and AF incidence was higher in never smokers than in current or ex-smokers (p<0.01). Conclusion: Current guidelines for the management of COPD do not sufficiently consider the increased risks associated with cardiovascular co-morbidities. This research highlights the need for timely diagnosis of cardiovascular co-morbidities and holistic, multi-disciplinary care to ensure optimal management of COPD and cardiovascular co-morbidities.