title: Central arterial stiffness is increased among subjects with severe and very severe COPD: report from a population-based cohort study.
abstract: BACKGROUND
  Cardiovascular disease (CVD) is common in chronic obstructive pulmonary disease (COPD) and is, as productive cough, related to poorer prognosis in COPD. Central arterial stiffness is a marker of early atherosclerosis, but the association between COPD, productive cough, and arterial stiffness as a possible indicator of CVD is unclear.
  
  
  OBJECTIVE
  To compare both arterial stiffness among subjects with and without COPD and the impact of productive cough in a population-based cohort.
  
  
  METHODS
  A population-based cohort, including 993 COPD and 993 non-COPD subjects, has been invited to annual examination since 2005. In 2010, 947 subjects, of which 416 had COPD (according to the GOLD spirometric criteria), participated in examinations including structured interview, spirometry, and measurements of central arterial stiffness as pulse wave velocity (PWV).
  
  
  RESULTS
  PWV was higher in GOLD 3-4 compared to non-COPD (10.52 vs. 9.13 m/s, p=0.042). CVD and age ≥60 were both associated with significantly higher PWV in COPD as well as in non-COPD. In COPD, those with productive cough had higher PWV than those without, significantly so in GOLD 1 (9.59 vs. 8.92 m/s, p=0.024). In a multivariate model, GOLD 3-4 but not productive cough was associated with higher PWV, when adjusted for sex, age group, smoking habits, blood pressure, CVD, and pulse rate.
  
  
  CONCLUSIONS
  GOLD 3-4, age ≥60, and CVD were associated with increased arterial stiffness, and also increased in COPD subjects with productive cough compared to those without. Of importance, GOLD 3-4 but not productive cough remained associated with increased central arterial stiffness when adjusted for confounders.
authors.affiliation: Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Linnea
authors.initials: L
authors.lastname: Qvist
authors.affiliation: Department of Public Health and Clinical Medicine, Division of Medicine, Umeå University, Umeå, Sweden.
authors.forename: Ulf
authors.initials: U
authors.lastname: Nilsson
authors.affiliation: OLIN Unit, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine, Umeå University, Umeå, Sweden.
authors.forename: Viktor
authors.initials: V
authors.lastname: Johansson
authors.affiliation: Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Kjell
authors.initials: K
authors.lastname: Larsson
authors.affiliation: OLIN Unit, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine, Umeå University, Umeå, Sweden.
authors.forename: Eva
authors.initials: E
authors.lastname: Rönmark
authors.affiliation: BHF Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, United Kingdom.
authors.forename: Jeremy
authors.initials: J
authors.lastname: Langrish
authors.affiliation: Department of Public Health and Clinical Medicine, Division of Medicine, Umeå University, Umeå, Sweden.
authors.forename: Anders
authors.initials: A
authors.lastname: Blomberg
authors.affiliation: Department of Public Health and Clinical Medicine, Division of Medicine, Umeå University, Umeå, Sweden.
authors.forename: Anne
authors.initials: A
authors.lastname: Lindberg
keywords: COPD; arterial stiffness; cardiovascular disease; epidemiology