{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T04:04:45Z","timestamp":1773288285696,"version":"3.50.1"},"reference-count":31,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,2,13]],"date-time":"2025-02-13T00:00:00Z","timestamp":1739404800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>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.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>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.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Multivariable logistic regression analysis showed that CVD and hypertension remained independently associated with COPD severity (<jats:italic>P<\/jats:italic>\u2009&amp;lt;\u20090.001). 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 (<jats:italic>P<\/jats:italic>\u2009&amp;lt;\u20090.05). Subgroup analyses showed that the association between CVD and COPD severity remained stable among men, patients\u2009\u2264\u200970 years of age, patients\u2009&amp;gt;\u200970 years of age, BMI\u2009&amp;lt;\u200924 or \u226524\u2005kg\/m<jats:sup>2<\/jats:sup>, and never smokers, whereas coronary artery disease was significantly associated with COPD severity only among patients\u2009\u2264\u200970 years of age and never smokers (<jats:italic>P<\/jats:italic>\u2009&amp;lt;\u20090.05). In addition, hypertension was also stably associated with COPD severity among men, patients\u2009\u2264\u200970 years of age, patients\u2009&amp;gt;\u200970 years of age, BMI\u2009&amp;lt;\u200924 or \u226524\u2005kg\/m<jats:sup>2<\/jats:sup>, 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 (<jats:italic>P<\/jats:italic>\u2009&amp;lt;\u20090.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>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.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fcvm.2025.1502205","type":"journal-article","created":{"date-parts":[[2025,2,13]],"date-time":"2025-02-13T07:09:15Z","timestamp":1739430555000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":3,"title":["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"],"prefix":"10.3389","volume":"12","author":[{"given":"Tianye","family":"Li","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lefu","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hao","family":"Xu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yanhong","family":"Zheng","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Heying","family":"Yang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hongjun","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chengshui","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,2,13]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1341","DOI":"10.1016\/S0140-6736(11)60968-9","article-title":"Chronic obstructive pulmonary disease","volume":"379","author":"Decramer","year":"2012","journal-title":"Lancet"},{"key":"B2","doi-asserted-by":"publisher","first-page":"10896","DOI":"10.3390\/ijerph191710896","article-title":"Metal exposure, smoking, and the risk of COPD: a nested case-control study in a Chinese occupational population","volume":"19","author":"Ma","year":"2022","journal-title":"Int J Environ Res Public Health"},{"key":"B3","doi-asserted-by":"publisher","first-page":"741","DOI":"10.1016\/S0140-6736(07)61377-4","article-title":"International variation in the prevalence of COPD (the BOLD study): a population-based prevalence study [published correction appears in Lancet. 2012 Sep 1;380(9844):806]","volume":"370","author":"Buist","year":"2007","journal-title":"Lancet"},{"key":"B4","doi-asserted-by":"publisher","first-page":"170103","DOI":"10.1183\/16000617.0103-2017","article-title":"Exacerbations of COPD","volume":"27","author":"Viniol","year":"2018","journal-title":"Eur Respir Rev"},{"key":"B5","doi-asserted-by":"publisher","first-page":"318","DOI":"10.1186\/s12890-023-02606-1","article-title":"Association between chronic obstructive pulmonary disease and cardiovascular disease in adults aged 40 years and above: data from NHANES 2013\u20132018","volume":"23","author":"Chen","year":"2023","journal-title":"BMC Pulm Med"},{"key":"B6","doi-asserted-by":"publisher","first-page":"1900651","DOI":"10.1183\/13993003.00651-2019","article-title":"Airway inflammation in COPD: progress to precision medicine","volume":"54","author":"Brightling","year":"2019","journal-title":"Eur Respir J"},{"key":"B7","doi-asserted-by":"publisher","first-page":"55","DOI":"10.1007\/978-3-030-33330-0_7","article-title":"Inflammation, frailty and cardiovascular disease","volume":"1216","author":"Soysal","year":"2020","journal-title":"Adv Exp Med Biol"},{"key":"B8","doi-asserted-by":"publisher","first-page":"48","DOI":"10.1016\/j.pupt.2018.06.004","article-title":"The pharmacological treatment of chronic comorbidities in COPD: mind the gap!","volume":"51","author":"Vespasiani-Gentilucci","year":"2018","journal-title":"Pulm Pharmacol Ther"},{"key":"B9","doi-asserted-by":"publisher","first-page":"1516","DOI":"10.1378\/chest.129.6.1516","article-title":"Use of peak oxygen consumption in predicting physical function and quality of life in COPD patients","volume":"129","author":"Berry","year":"2006","journal-title":"Chest"},{"key":"B10","doi-asserted-by":"publisher","first-page":"497","DOI":"10.1378\/chest.08-0117","article-title":"Continuous oxygen use in nonhypoxemic emphysema patients identifies a high-risk subset of patients: retrospective analysis of the national emphysema treatment trial","volume":"134","author":"Drummond","year":"2008","journal-title":"Chest"},{"key":"B11","doi-asserted-by":"publisher","first-page":"180057","DOI":"10.1183\/16000617.0057-2018","article-title":"Cardiovascular disease and COPD: dangerous liaisons? 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