RT Journal Article
SR Electronic
T1 Increased arterial stiffness in patients with chronic obstructive pulmonary disease: a mechanism for increased cardiovascular risk
JF Thorax
JO Thorax
FD BMJ Publishing Group Ltd and British Thoracic Society
SP 306
OP 311
DO 10.1136/thx.2007.083493
VO 63
IS 4
A1 N L Mills
A1 J J Miller
A1 A Anand
A1 S D Robinson
A1 G A Frazer
A1 D Anderson
A1 L Breen
A1 I B Wilkinson
A1 C M McEniery
A1 K Donaldson
A1 D E Newby
A1 W MacNee
YR 2008
UL http://thorax.bmj.com/content/63/4/306.abstract
AB Rationale: Chronic obstructive pulmonary disease (COPD) is associated with a 2–3-fold increase in the risk of ischaemic 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 with age and smoking matched controls.Methods: In a prospective case control study, we recruited 102 patients with COPD and 103 healthy controls matched for age and smoking status. Patients were assessed by clinical history and spirometry, with arterial stiffness and blood pressure determined using radial artery applanation tonometry and sphygmomanometry.Results: Patients with COPD had increased arterial stiffness compared with matched controls, with elevated augmentation pressure (17 (1) vs 14 (1) mm Hg; 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) mm Hg; p = 0.005) and systolic blood pressure (147 (2) vs 132 (2) mm Hg; p<0.001). Serum C reactive protein concentrations were threefold 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 controls matched for age and smoking status. We speculate that increased systemic inflammation and vascular dysfunction could potentially explain the excess cardiovascular morbidity and mortality associated with COPD.