The speed of blood pressure fluctuations in patients with chronic obstructive pulmonary disease.
BACKGROUND
Chronic obstructive pulmonary disease (COPD) has been associated with increased risk for cardiovascular disease but mechanisms underlying this association are incompletely understood. The speed of beat-to-beat changes in systolic blood pressure (vSBP) was found to be pronounced in patients with elevated cardiovascular risk. Although increased vSBP may thus be a contributing mechanism to cardiovascular morbidity, no data exist on vSBP in patients with COPD. Therefore, the purpose of this study was to evaluate whether there is an association between severity of COPD and vSBP.


METHODS
Resting beat-to-beat blood pressure was recorded during 5 min. vSBP was assessed by calculating the slopes of oscillatory fluctuations in SBP for different inter-beat intervals (IBI). Univariate and multivariate analyses were performed to evaluate the association between forced expiratory volume in 1 s (FEV1) and vSBP.


RESULTS
This study comprised 60 patients with COPD (24 females) with a mean [SD] FEV1 of 45.4 [22.7] %predicted and 34 healthy controls. Short-term fluctuations in SBP were more pronounced in patients with COPD compared to healthy controls. There was a significant inverse correlation between FEV1 and vSBP (r=-0.41, p=0.001). Even after adjustment for covariates in multivariate analysis, FEV1 was found to be independently associated with vSBP.


CONCLUSIONS
Patients with COPD are characterised by steeper blood pressure changes than healthy controls. The speed of fluctuations in SBP is associated with the severity of airflow limitation. Increased vSBP may be a mechanism underpinning the association between COPD and cardiovascular disease.
Pulmonary Division, University Hospital of Zurich, Zurich, Switzerland; Department of Health, Zurich University of Applied Sciences, Winterthur, Switzerland. Electronic address: vrns@zhaw.ch.
Arnoldus J R
AJ
van Gestel
Pulmonary Division, University Hospital of Zurich, Zurich, Switzerland. Electronic address: christian.clarenbach@usz.ch.
Christian F
CF
Clarenbach
Pulmonary Division, University Hospital of Zurich, Zurich, Switzerland. Electronic address: Anne-Christin.Stoewhas@usz.ch.
Anne-Christin
AC
Stöwhas
Pulmonary Division, University Hospital of Zurich, Zurich, Switzerland. Electronic address: rossi.valentina@usz.ch.
Valentina A
VA
Rossi
Pulmonary Division, University Hospital of Zurich, Zurich, Switzerland. Electronic address: noriane.sievi@usz.ch.
Noriane A
NA
Sievi
Pulmonary Division, University Hospital of Zurich, Zurich, Switzerland. Electronic address: giovanni.camen@usz.ch.
Giovanni
G
Camen
Pulmonary Division, University Hospital of Zurich, Zurich, Switzerland; Center for Integrative Human Physiology, University of Zurich, Zurich, Switzerland. Electronic address: malcolm.kohler@usz.ch.
Malcolm
M
Kohler
D000328:Adult; D000368:Aged; D001794:Blood Pressure; D002318:Cardiovascular Diseases / Q000209:etiology / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications / Q000503:physiopathology*; D012307:Risk Factors
Blood pressure variability; Cardiovascular risk; Changes; Chronic obstructive pulmonary disease; Forced expiratory volume in 1s; Speed of blood pressure