Arterial stiffness and osteoporosis in chronic obstructive pulmonary disease.
BACKGROUND
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.


OBJECTIVE
We tested 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.


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 log(10) IL-6 (r = 0.31, p < 0.01), and inversely to FEV(1) (r = -0.34, p < 0.01). The strongest predictors of aortic PWV in all subjects were age (p < 0.0001), percent predicted FEV(1) (p < 0.05), mean arterial pressure (p < 0.05), and log(10) 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.
Sabit
Ramsey
R
Department of Respiratory Medicine, Cardiff University, Academic Centre, Llandough Hospital, Penlan Road, Penarth, Vale of Glamorgan CF64 2XX, UK.
Bolton
Charlotte E
CE
Edwards
Peter H
PH
Pettit
Rebecca J
RJ
Evans
William D
WD
McEniery
Carmel M
CM
Wilkinson
Ian B
IB
Cockcroft
John R
JR
Shale
Dennis J
DJ
D015502:Absorptiometry, Photon; D000368:Aged; D019588:Aging, Premature / Q000453:epidemiology / Q000503:physiopathology; D001823:Body Composition; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000503:physiopathology; D004548:Elasticity; D005260:Female; D006801:Humans; D007249:Inflammation / Q000453:epidemiology* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000453:epidemiology* / Q000503:physiopathology; D029424:Pulmonary Disease, Chronic Obstructive / Q000453:epidemiology* / Q000503:physiopathology; D012129:Respiratory Function Tests; D012307:Risk Factors