Arterial stiffness and osteoporosis in chronic obstructive pulmonary disease

Ramsey Sabit, Charlotte E. Bolton, Peter H. Edwards, Rebecca J. Pettit, William D. Evans, Carmel M. McEniery, Ian B. Wilkinson, John R. Cockcroft, Dennis J. Shale*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

294 Citations (Scopus)

Abstract

Rationale: Chronic obstructive pulmonary disease (COPD) is associated with an increased risk of cardiovascular events and osteoporosis. Increased arterial stiffness is an independent predictor of cardiovascular disease. Objectives: Wetested the hypothesis that patients with COPD would have increased arterial stiffness, which would be associated with osteoporosis and systemic inflammation. Methods: We studied 75 clinically stable patients with a range of severity of airway obstruction and 42 healthy smoker or ex-smoker control subjects, free of cardiovascular disease. All subjects underwent spirometry, measurement of aortic pulse wave velocity (PWV) and augmentation index, dual-energy X-ray absorptiometry, and blood sampling for inflammatory mediators. Measurements and Main Results: Mean (SD) aortic PWV was greater in patients, 11.4 (2.7) m/s, than in control subjects, 8.95 (1.7) m/s, p < 0.0001. Inflammatory mediators and augmentation index were also greater in patients. Patients with osteoporosis at the hip had a greater aortic PWV, 13.1 (1.8) m/s, than those without, 11.2 (2.7) m/s, p < 0.05. In patients, aortic PWV was related to age (r = 0.63, p < 0.0001) and log10 IL-6 (r = 0.31, p < 0.01), and inversely to FEV1 (r = -0.34, p < 0.01). The strongest predictors of aortic PWV in all subjects were age (p < 0.0001), percent predicted FEV1 (p < 0.05), mean arterial pressure (p < 0.05), and log10 IL-6 (p < 0.05). Conclusions: Increased arterial stiffness was related to the severity of airflow obstruction and may be a factor in the excess risk for cardiovascular disease in COPD. The increased aortic PWV in patients with osteoporosis and the association with systemic inflammation suggest that age-related bone and vascular changes occur prematurely in COPD.

Original languageEnglish
Pages (from-to)1259-1265
Number of pages7
JournalAmerican Journal of Respiratory and Critical Care Medicine
Volume175
Issue number12
DOIs
Publication statusPublished - 15 Jun 2007

Keywords

  • Arterial stiffness
  • Cardiovascular disease
  • Chronic obstructive pulmonary disease
  • Osteoporosis
  • Systemic inflammation

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