Systemic inflammation and increased arterial stiffness in patients with chronic obstructive pulmonary disease
J. J. Miller, A. Anand, S. D. Robinson, I. B. Wilkinson, C. M. McEniery, G. A. Frazer, I. B. Wilkinson, K. Donaldson, D. E. Newby, W. MacNee, N. L. Mills (Edinburgh, Cambridge, United Kingdom)
Source: Annual Congress 2006 - COPD and inflammation
Session: COPD and inflammation
Session type: Oral Presentation
Number: 1998
Disease area: Airway diseases, Pulmonary vascular diseases
Abstract Chronic obstructive pulmonary disease (COPD) is an important risk factor for atherosclerosis and is associated with a 2-3 fold increase in risk of ischaemic heart disease, stroke and sudden death. The mechanisms responsible for this association are not clear and appear to be independent of smoking history. Methods: In a prospective case-control study we recruited 102 patients with COPD, and 103 age- and smoking history-matched healthy controls. Patients were assessed by clinical history and spirometry with arterial stiffness and blood pressure determined using radial artery applanation tonometry and sphygmomanometry. A highly sensitive assay was used to determine serum C-reactive protein concentrations. Results: Patients with COPD (FEV1 45±2% predicted) had increased arterial stiffness compared to matched controls, with elevated augmentation pressure (16.7±0.9 vs. 12.5±0.7 mmHg; p<0.001), and a reduced time to wave reflection (131.3±1.1 vs. 139.0±1.8 ms; p<0.001). These differences were associated with increases in both diastolic (82.0±1.2 vs. 74.3±0.7 mmHg; p<0.001) and systolic blood pressure (147±2.3 vs. 126.5±2.0 mmHg; p<0.001). Serum C-reactive protein concentrations were three fold higher in patients than in controls (6.1±0.9 vs. 2.3±0.4 mg/L; p=0.001). Conclusion: Patients with COPD have increased arterial stiffness and blood pressure in comparison with age- and smoking-history matched controls. Upregulation of pro-atherogenic inflammatory pathways and vascular dysfunction may explain the excess cardiovascular morbidity and mortality associated with COPD and provide a rationale for designing novel therapeutic interventions.
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J. J. Miller, A. Anand, S. D. Robinson, I. B. Wilkinson, C. M. McEniery, G. A. Frazer, I. B. Wilkinson, K. Donaldson, D. E. Newby, W. MacNee, N. L. Mills (Edinburgh, Cambridge, United Kingdom). Systemic inflammation and increased arterial stiffness in patients with chronic obstructive pulmonary disease. Eur Respir J 2006; 28: Suppl. 50, 1998
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