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Premature Vascular and Bone Changes Occur in COPD Patients

rterial stiffness. Increased arterial stiffness was present in patients with COPD over a wide range of severity of airway obstruction and was greatest in those with osteoporosis, said Dr. Shale. Our findings indicate vascular changes predictive of cardiovascular disease occur and remain undetected in mild or early lung disease and may underlie the excess cardiovascular risk in COPD.

The researchers noted that age was an important factor influencing arterial stiffness, a problem that reflects the increasing rigidity of the aortic artery. The average age of the study cohort was 63. The increased arterial stiffness in patients within each decade is similar to changes seen in type I diabetes mellitus and suggest that age-related vascular changes occur prematurely in COPD, as compared with disease-free individuals, said Dr. Shale. However, unlike diabetes mellitus, the risk of premature excess cardiovascular disease in COPD is not appreciated.

At the beginning of the study, none of the participants had a history of heart disease or possessed cardiovascular symptoms. Of the 75 COPD patients studied, 18 had osteoporosis, while among the controls, only two individuals suffered from abnormal loss of bony tissue. Also, those who had osteoporosis of the hip had a greater aortic pulse wave velocity than those without the hip problem.

In an editorial on the study in the same issue of the journal, Claus Vogelmeier, M.D., and Robert Bals, M.D., of Philipps-University, Marburg in Germany, said that the study provides important new information on the relationship of cardiovascular disease and COPD.

They noted that aortic pulse wave velocityconsidered the most clinically relevant measure of arterial stiffnesshas been shown to predict cardiovascular outcome in various populations. The authors also highlighted the studys correlation of pulse wave velocity and COPD severity as important.

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