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Rapid progression of central arterial stiffness in copd: preliminary 2 year follow-up data from the ARCADE study

Albarrati, Ali M., Gale, Nichola S., Munnery, Margaret, Munnery, Iain C., McEniery, Carmel, Tal-Singer, Ruth, Shale, Dennis J. and Cockcroft, John Ronald 2014. Rapid progression of central arterial stiffness in copd: preliminary 2 year follow-up data from the ARCADE study. Journal of the American Society of Hypertension 8 (4) , e4-e5. 10.1016/j.jash.2014.03.013

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Abstract

Background Patients with COPD have increased risk of cardiovascular (CV) events and mortality beyond that attributable to smoking. Aortic pulse wave velocity (aPWV) is a validated measure of arterial stiffness and an independent predictor of cardiovascular (CV) outcomes, which is elevated in patients with COPD. However, there have been no longitudinal studies of arterial stiffness in COPD. The ARCADE is a longitudinal study of CV risk and comorbidities. We hypothesised that patients with COPD would have increased progression of PWV than a historical comparator group. Methods Thus far 108 patients with COPD have completed the 2 year follow-up assessment. These have been compared to 38 historical controls (free from respiratory disease). Assessments include spirometry, BMI, waist circumference (WC), aPWV and blood pressure (BP). Results Patients and comparators were similar in gender, BMI and BP, but patients were older; mean (SD) age 68 (7), comparators 62 (8) years and had greater WC and aPWV, all p<0.05, (Figure 1). In contrast to the comparator group, patients with COPD had a significant increase in PWV 0.74m/s (95%CI: 0.41 to 1.1) after 2 years, independent of baseline age, FEV1% predicted, BMI, WC and mean arterial pressure. There was no change in BP other than a small reduction in diastolic BP (2mmHg) (p=0.025). Conclusions The increased rate of aPWV progression in COPD, independent of traditional risk factors suggests an alternative mechanism for accelerated aortic stiffness in COPD. Further longitudinal assessments of a larger prospective comparator group will inform the understanding of the rate and cause of arterial stiffness. Furthermore, defining differences between patients with COPD in terms of progression / non-progression of aPWV may elucidate the mechanisms involved and identify potential targets for therapeutic intervention.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Healthcare Sciences
Subjects: R Medicine > R Medicine (General)
Uncontrolled Keywords: Central Arterial Stiffness; COPD; Progression
Publisher: Elsevier
ISSN: 1933-1711
Last Modified: 13 Nov 2019 15:24
URI: http://orca.cf.ac.uk/id/eprint/82198

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