Association between airway obstruction and peripheralarterial stiffness in elderly patients with chronic obstructive pulmonary disease / 中华老年医学杂志

ABSTRACT

Objective To evaluate the relationship between severity of airway obstruction and peripheral arterial stiffness in patients with chronic obstructive pulmonary disease (COPD).Methods 81 COPD patients [aged (78.32 ± 6.98)yrs,73 males,8 females] from Jan 2008 to Oct 2012 were enrolledin Geriatric Department of Peking University First Hospital.All patients underwent spirometry and Holter evaluation,while age,sex,BMI,smoking pack-years,medical history,blood levels of lipid profiles,glucose,high sensitivity C reactive protein (hsCRP)and arterial oxygen pressure (PaO2)were recorded.The severity of airway obstruction was evaluated by spirometry.The patients were divided into two groupsmild/moderate group [forced expiratory volume in one second (FEV1％) predicted ≥ 50 ％,n=51] and severe group (FEV1％ predicted ＜ 50％,n=30).24-hour average heart rate (HR)was assessed by holter.Arterial stiffness was assessed by the brachial ankle pulse wave velocity (baPWV).The baPWV increment was considered to be a direct witness of arterial stiffness increase.Blood levels of lipid profiles,glucose,arterial oxygen pressure (PaO2)and hsCRP were compared between the two groups.Results Age,gender,smoking index,medical history of the two groups were matched.BMI was less in severe group than in mild/moderate group [(22.8± 4.2) kg/m2 vs.(25.3± 3.2) kg/m2,t=3.017,P＜0.05].24-hour average HR was higher in severe group than in mild/moderate group [(77.4± 12.7)bpm vs.(70.8± 9.6)bpm,t=-2.602,P＜0.05].The PaO2 was lower in severe group than in mild/moderate group [(74.6±13.0)mmHg vs.(82.4± 13.1)mmHg,t=2.456,P＜0.05].There were no differences in blood lipid profile and glucose levels between the two groups.76 patients (93.4％)were detected with peripheral arterial stiffness by baPWV＞14.00 m/s.baPWV was significantly increased in severe group as compared with mild/moderate group [(20.77 ± 3.71) m/s vs.(18.84 ± 1.88) m/s,t=-2.109,P＜0.05].hsCRP was significantly higher in severe group than in mild/moderate group [[(6.51±5.66)mg/L vs.(3.27±3.34)mg/L,t=-2.658,P＜0.01].Conclusions The morbidity of peripheral arterial stiffness is increased in patients with COPD.Progression of arterial stiffness is related to the severity of airway obstruction,which may be related to chronic inflammation,hypoxia,or excessive sympathetic activation.