Abstract

Rationale Chronic obstructive pulmonary disease (COPD) is associated with a 2-3 fold increase in the risk of ischemic heart disease, stroke and sudden death. The mechanisms responsible for this association are not clear and appear to be independent of smoking history.

Objective We test the hypothesis that patients with COPD have increased arterial stiffness and blood pressure in comparison to age and smoking matched controls.

Methods and Main Results In a prospective case-control study, we recruited 102 patients with COPD and 103 age- and smoking status-matched healthy controls. Patients were assessed by clinical history and spirometry with arterial stiffness and blood pressure determined using radial artery applanation tonometry and sphygmomanometry. Patients with COPD had increased arterial stiffness when compared to matched controls, with elevated augmentation pressure (17(1) vs. 14(1) mmHg; p=0.005), and a reduced time to wave reflection (131(1) vs. 137(2) ms; p=0.004). These differences were associated with increases in both diastolic (82(1) vs. 78(1) mmHg; p=0.005) and systolic blood pressure (147(2) vs. 132(2) mmHg; p<0.001). High-sensitive serum C-reactive protein concentrations were 3-fold higher in patients (6.1(0.9) vs. 2.3(0.4) mg/L; p=0.001). Data are presented as mean (SEM).

Conclusions Patients with COPD have increased arterial stiffness and blood pressure in comparison with age- and smoking status-matched controls. We speculate that increased systemic inflammation and vascular dysfunction could potentially explain the excess cardiovascular morbidity and mortality associated with COPD.