Prevalence of exacerbated chronic obstructive pulmonary disease with comorbid pulmonary hypertension: a systematic review and meta-analysis

INTRODUCTION: The heart and lungs are interconnected organs. When one develops a pathology, it can interfere with the other's function. One of the most common lung diseases is chronic obstructive pulmonary disease (COPD). Cardio-vascular disorders are a major cause of COPD morbidity and mortality. Pulmonary hypertension (PH) is a COPD co -morbidity associated with respiratory tract infections and COPD exacerbation. This systematic review and meta-analysis aimed to determine the prevalence of COPD exacerbations with comorbid PH.EVIDENCE ACQUISITION: This systematic review considered articles published from 2012 to 2022. English articles in the PubMed and Google Scholar electronic databases were searched using a series of keywords, including COPD, exacerbation, PH, and prevalence, combined using Boolean logic operators. The identified articles were meta-analyzed according to PRISMA guidelines.EVIDENCE SYNTHESIS: Six articles were included in the meta-analysis. A subgroup analysis considering each World Health Organization region indicated the prevalence of exacerbated COPD with comorbid PH was 66.7% (95% CI: 0-100%) in Asia, 65.1% (95% CI: 0-100%) in Europe, 10.4% (95% CI: 10.8-11.0%) in North America, and 3.6% (95% CI: 4.0-4.4%) in South America. The age of patients experiencing exacerbated COPD with comorbid PH was >60 years (62-72; 75 +/- 2). In addition, the prevalence of exacerbated COPD with PH varied between males and females among studies.CONCLUSIONS: Exacerbated COPD with comorbid PH was more common in Asia and Europe than in North and South America. Its prevalence was higher in patients aged >60 years and varied by sex and GOLD categories.