help button home button
AJRCCM
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Published ahead of print on March 15, 2007, doi:10.1164/rccm.200701-067OC
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow All Versions of this Article:
200701-067OCv1
175/12/1259    most recent
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Related articles in AJRCCM
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Sabit, R.
Right arrow Articles by Shale, D. J.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Sabit, R.
Right arrow Articles by Shale, D. J.
American Journal of Respiratory and Critical Care Medicine Vol 175. pp. 1259-1265, (2007)
© 2007 American Thoracic Society
doi: 10.1164/rccm.200701-067OC

Original Article

Arterial Stiffness and Osteoporosis in Chronic Obstructive Pulmonary Disease

Ramsey Sabit1, Charlotte E. Bolton1, Peter H. Edwards2, Rebecca J. Pettit3, William D. Evans3, Carmel M. McEniery4, Ian B. Wilkinson4, John R. Cockcroft5 and Dennis J. Shale1

1 Department of Respiratory Medicine, Cardiff University, Academic Centre, Llandough Hospital, Penarth, Vale of Glamorgan; 2 on behalf of Ely Bridge Surgery, Ely, Cardiff; 3 Department of Medical Physics and Clinical Engineering, University Hospital of Wales, Heath Park, Cardiff; 4 Department of Clinical Pharmacology, University of Cambridge, Addenbrooke's Hospital, Cambridge; and 5 Department of Cardiology, Cardiff University, Wales Heart Research Institute, University Hospital of Wales, Cardiff, United Kingdom

Correspondence and requests for reprints should be addressed to D. J. Shale, M.D., Department of Respiratory Medicine, Cardiff University, Academic Centre, Llandough Hospital, Penlan Road, Penarth, Vale of Glamorgan CF64 2XX, UK. E-mail: shaledj{at}cardiff.ac.uk

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: 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.

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.

Key Words: chronic obstructive pulmonary disease • cardiovascular disease • arterial stiffness • osteoporosis • systemic inflammation


AT A GLANCE COMMENTARY

Scientific Knowledge on the Subject
Patients with chronic obstructive pulmonary disease (COPD) are at increased risk of cardiovascular disease and osteoporosis even when confounding factors are taken into account. The mechanisms linking COPD and cardiovascular disease are not known.

What This Study Adds to the Field
The excess cardiovascular risk in COPD may be due to increased arterial stiffness, which is related to airflow obstruction, systemic inflammation, and the presence of osteoporosis.

 

Related articles in AJRCCM:

Chronic Obstructive Pulmonary Disease and Premature Aging
Claus Vogelmeier and Robert Bals
AJRCCM 2007 175: 1217-1218. [Full Text]  



This article has been cited by other articles:


Home page
 Am. J. Respir. Crit. Care Med.Home page
P. Eickhoff, A. Valipour, D. Kiss, M. Schreder, L. Cekici, K. Geyer, R. Kohansal, and O. C. Burghuber
Determinants of Systemic Vascular Function in Patients with Stable Chronic Obstructive Pulmonary Disease
Am. J. Respir. Crit. Care Med., December 15, 2008; 178(12): 1211 - 1218.
[Abstract] [Full Text] [PDF]

Home page
 Proc Am Thorac SocHome page
W. MacNee, J. Maclay, and D. McAllister
Cardiovascular Injury and Repair in Chronic Obstructive Pulmonary Disease
Proceedings of the ATS, December 1, 2008; 5(8): 824 - 833.
[Abstract] [Full Text] [PDF]

Home page
 Proc Am Thorac SocHome page
F. Luppi, F. Franco, B. Beghe, and L. M. Fabbri
Treatment of Chronic Obstructive Pulmonary Disease and Its Comorbidities
Proceedings of the ATS, December 1, 2008; 5(8): 848 - 856.
[Abstract] [Full Text] [PDF]

Home page
 Proc Am Thorac SocHome page
P. J. Barnes
Future Treatments for Chronic Obstructive Pulmonary Disease and Its Comorbidities
Proceedings of the ATS, December 1, 2008; 5(8): 857 - 864.
[Abstract] [Full Text] [PDF]

Home page
 Eur Respir JHome page
P. Albert and P. M. A. Calverley
Drugs (including oxygen) in severe COPD
Eur. Respir. J., May 1, 2008; 31(5): 1114 - 1124.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
W. MacNee
Update in Chronic Obstructive Pulmonary Disease 2007
Am. J. Respir. Crit. Care Med., April 15, 2008; 177(8): 820 - 829.
[Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
A. Boussuges and M. Gouitaa
Arterial Stiffness and Chronic Obstructive Pulmonary Disease
Am. J. Respir. Crit. Care Med., April 15, 2008; 177(8): 929 - 929.
[Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
R. Sabit, C. E. Bolton, J. R. Cockcroft, and D. J. Shale
Arterial Stiffness and Chronic Obstructive Pulmonary Disease
Am. J. Respir. Crit. Care Med., April 15, 2008; 177(8): 929 - 930.
[Full Text] [PDF]

Home page
 Eur Respir JHome page
L. M. Fabbri, F. Luppi, B. Beghe, and K. F. Rabe
Complex chronic comorbidities of COPD
Eur. Respir. J., January 1, 2008; 31(1): 204 - 212.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
R. Sabit and D. J. Shale
Vascular Structure and Function in Chronic Obstructive Pulmonary Disease: A Chicken and Egg Issue?
Am. J. Respir. Crit. Care Med., December 15, 2007; 176(12): 1175 - 1176.
[Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
D. A. McAllister, J. D. Maclay, N. L. Mills, G. Mair, J. Miller, D. Anderson, D. E. Newby, J. T. Murchison, and W. MacNee
Arterial Stiffness Is Independently Associated with Emphysema Severity in Patients with Chronic Obstructive Pulmonary Disease
Am. J. Respir. Crit. Care Med., December 15, 2007; 176(12): 1208 - 1214.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
C. Vogelmeier and R. Bals
Chronic Obstructive Pulmonary Disease and Premature Aging
Am. J. Respir. Crit. Care Med., June 15, 2007; 175(12): 1217 - 1218.
[Full Text] [PDF]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Proc. Am. Thorac. Soc. Am. J. Respir. Cell Mol. Biol.
Copyright © 2007 American Thoracic Society 		  2009/2010 ATS Fellows Career Development Awards