Relationship between FEV1 and arterial stiffness in elderly people with chronic obstructive pulmonary disease

Aging Clin Exp Res. 2017 Apr;29(2):157-164. doi: 10.1007/s40520-016-0560-3. Epub 2016 Mar 21.

Abstract

Background: Chronic obstructive pulmonary disease (COPD) is highly prevalent in the elderly, and both COPD and age per se are associated with cardiovascular morbidity.

Aims: We tested the hypothesis that in elderly COPD patients airflow limitation is associated with arterial stiffness and the relationship, if any, is related to endothelial function and systemic inflammation.

Methods: We evaluated lung function, augmentation index (AIx), flow-mediated dilation (FMD), Interleukin-6 (IL-6), and asymmetric dymethilarginine (ADMA) levels in 76 subjects (mean age 73.9 years, SD 6.2) attending a geriatric outpatient clinic.

Results: Participants with COPD (N = 41) and controls (N = 35) did not differ in terms of AIx (30 vs 28.2 %, P = 0.30) and FMD (14.2 vs 12.3 %, P = 0.10). Similarly, the two groups did not differ with respect to mean concentrations of inflammation markers (IL-6 and C-reactive protein) and ADMA. Among COPD participants there was an inverse correlation between AIx and Forced Expiratory Volume in the first second (r = -0.349, P = 0.02). This relationship remained significant after correction for potential confounders, including markers of inflammation and ADMA levels (β = -0.194, P = 0.001).

Discussion: According to the results of this study, among COPD patients, bronchial patency and AIx are inversely related, and the relationship is explained neither by endothelial function nor by systemic inflammation.

Conclusions: In elderly COPD people, increased arterial stiffness is related to reduced pulmonary function and it seems worth testing as a potential marker of higher cardiovascular risk.

Keywords: Aged; Arterial stiffness; Augmentation Index; Chronic obstructive pulmonary disease; Pulmonary function tests.

MeSH terms

  • Aged
  • Arginine / analogs & derivatives*
  • Arginine / metabolism
  • Biomarkers / metabolism
  • C-Reactive Protein / metabolism*
  • Cardiovascular Diseases* / epidemiology
  • Cardiovascular Diseases* / physiopathology
  • Endothelium, Vascular / physiopathology
  • Female
  • Forced Expiratory Volume
  • Humans
  • Inflammation* / metabolism
  • Inflammation* / physiopathology
  • Interleukin-6 / metabolism*
  • Italy
  • Male
  • Middle Aged
  • Pulmonary Disease, Chronic Obstructive* / complications
  • Pulmonary Disease, Chronic Obstructive* / epidemiology
  • Pulmonary Disease, Chronic Obstructive* / physiopathology
  • Risk Factors
  • Statistics as Topic
  • Vascular Stiffness

Substances

  • Biomarkers
  • Interleukin-6
  • N,N-dimethylarginine
  • C-Reactive Protein
  • Arginine