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BMC Pulmonary Medicine

, 14:1

COPD and occupational lung disease

Abstract

BackgroundCardiovascular morbidity and mortality is high in patients with chronic obstructive pulmonary disease COPD and arterial stiffness is a potentially modifiable risk factor with added predictive value beyond that obtained from traditional risk factors. Arterial stiffness has been the target of pharmacologic and exercise interventions in patients with COPD, but the effects appear limited to those patients with more significant elevations in arterial stiffness. We aimed to identify predictors of increased arterial stiffness in a cohort with moderate to severe COPD.

MethodsAortic pulse wave velocity aPWV was measured in subjects with moderate to severe COPD enrolled in a multicenter randomized controlled trial. Subjects were categorized into quartiles based on aPWV values and factors affecting high arterial stiffness were assessed. Multivariate models were created to identify independent predictors of high aPWV, and cardiovascular disease CVD.

Results153 patients were included. Mean age was 63.2 SD 8.2 years and mean FEV1 was 55.4 SD 15.2 % predicted. Compared to the quartile with the lowest aPWV, subjects in the highest quartile were older, had higher systolic blood pressure SBP, were more likely to be current smokers, and had greater burden of thoracic aortic calcification. On multivariate analyses, age adjusted OR 1.14, 95%CI 1.05 to 1.25, p = 0.003 and SBP adjusted OR 1.06, 95% CI 1.02 to 1.09, p = 0.001 were independent predictors of elevated aPWV. Body mass index, therapy with cholesterol lowering medications and coronary calcification were independent predictors of CVD.

ConclusionsElevated arterial stiffness in patients with COPD can be predicted using age, blood pressure and thoracic aortic calcification. This will help identify subjects for enrollment in clinical trials using aPWV for assessing the impact of COPD therapies on CV outcomes.

Trial registrationClinicaltrials.gov NCT00857766

KeywordsCOPD Arterial stiffness Arterial calcification Cardiovascular Electronic supplementary materialThe online version of this article doi:10.1186-1471-2466-14-1 contains supplementary material, which is available to authorized users.

Surya P Bhatt, Adam G Cole contributed equally to this work.

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Autor: Surya P Bhatt - Adam G Cole - James Michael Wells - Hrudaya Nath - Jubal R Watts - John R Cockcroft - Mark T Dransfie

Fuente: https://link.springer.com/



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