title: Airflow limitation in smokers is associated with arterial stiffness: the Nagahama Study.
abstract: BACKGROUND
  Pathophysiological mechanisms of associations between airflow limitation (AL) and arterial stiffness remain unclear. One factor that might affect both AL and arterial stiffness is habitual smoking. The aim of this study is to investigate a possible interaction of smoking on the association between AL and arterial stiffness.
  
  
  METHODS
  Study subjects consisted of 8790 apparently healthy community residents. Airflow limitation was defined as a ratio of forced expiratory volume in 1 s (FEV1) to forced vital capacity of less than 70%. Brachial-to-ankle pulse wave velocity (baPWV) was used as an index of arterial stiffness. Smoking habit was investigated using a structured questionnaire.
  
  
  RESULTS
  Subjects with AL had significantly higher baPWV (AL 1381 ± 334, control 1261 ± 227 cm/s, p < 0.001). In a separate analysis by smoking habit, advanced arterial stiffness in AL was observed only in smokers (non-smokers: AL 1300 ± 220, control 1260 ± 218; smokers: AL 1436 ± 384, control 1264 ± 243 cm/s). Other clinical features of subjects with AL were older age; increased plasma hsCRP levels; and a high prevalence of male sex, hypertension, and smoking experience. Multiple linear regression analysis adjusted for these covariates identified the smoking × AL interaction as an independent determinant of baPWV (β = 0.066, p < 0.001). Conversely, baPWV was an independent determinant of AL in current and past smokers, but not in never smokers.
  
  
  CONCLUSIONS
  AL arising from cigarette smoking, but not AL in non-smokers, was associated with arterial stiffness in a general population independently of established risk factors. Measurement of subclinical arterial change in smokers may be useful in identifying persons at risk for AL.
authors.affiliation: Center for Genomic Medicine, Kyoto University Graduate School of Medicine, Shogoinkawaramachi, Sakyo-ku, Kyoto 606-8507, Japan. Electronic address: yasuharu.tabara@gmail.com.
authors.forename: Yasuharu
authors.initials: Y
authors.lastname: Tabara
authors.affiliation: Department of Respiratory Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan.
authors.forename: Shigeo
authors.initials: S
authors.lastname: Muro
authors.affiliation: Department of Health Informatics, Kyoto University School of Public Health, Kyoto, Japan.
authors.forename: Yoshimitsu
authors.initials: Y
authors.lastname: Takahashi
authors.affiliation: Center for Genomic Medicine, Kyoto University Graduate School of Medicine, Shogoinkawaramachi, Sakyo-ku, Kyoto 606-8507, Japan.
authors.forename: Kazuya
authors.initials: K
authors.lastname: Setoh
authors.affiliation: Center for Genomic Medicine, Kyoto University Graduate School of Medicine, Shogoinkawaramachi, Sakyo-ku, Kyoto 606-8507, Japan.
authors.forename: Takahisa
authors.initials: T
authors.lastname: Kawaguchi
authors.affiliation: Center for Genomic Medicine, Kyoto University Graduate School of Medicine, Shogoinkawaramachi, Sakyo-ku, Kyoto 606-8507, Japan.
authors.forename: Chikashi
authors.initials: C
authors.lastname: Terao
authors.affiliation: Department of Medical Ethics and Medical Genetics, Kyoto University School of Public Health, Kyoto, Japan.
authors.forename: Shinji
authors.initials: S
authors.lastname: Kosugi
authors.affiliation: EBM Research Center, Kyoto University Graduate School of Medicine, Kyoto, Japan.
authors.forename: Akihiro
authors.initials: A
authors.lastname: Sekine
authors.affiliation: Center for Genomic Medicine, Kyoto University Graduate School of Medicine, Shogoinkawaramachi, Sakyo-ku, Kyoto 606-8507, Japan.
authors.forename: Ryo
authors.initials: R
authors.lastname: Yamada
authors.affiliation: Department of Health Informatics, Kyoto University School of Public Health, Kyoto, Japan.
authors.forename: Takeo
authors.initials: T
authors.lastname: Nakayama
authors.affiliation: Department of Respiratory Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan.
authors.forename: Michiaki
authors.initials: M
authors.lastname: Mishima
authors.affiliation: Center for Genomic Medicine, Kyoto University Graduate School of Medicine, Shogoinkawaramachi, Sakyo-ku, Kyoto 606-8507, Japan.
authors.forename: Fumihiko
authors.initials: F
authors.lastname: Matsuda
mesh_terms: D000368:Aged; D001916:Brachial Artery / Q000473:pathology; D002097:C-Reactive Protein / Q000378:metabolism; D015331:Cohort Studies; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D006973:Hypertension / Q000097:blood; D007564:Japan; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D029424:Pulmonary Disease, Chronic Obstructive / Q000209:etiology; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects*; D011795:Surveys and Questionnaires; D062789:Tobacco Products / Q000009:adverse effects; D059289:Vascular Stiffness; D014797:Vital Capacity
chemical_list: D002097:C-Reactive Protein
keywords: Airflow limitation; Arterial stiffness; Chronic obstructive pulmonary diseases; Pulse wave velocity; Smoking