Airflow limitation as a risk factor for vascular stiffness

BACKGROUND: Cardiovascular disease is one of the main causes of mortality in patients with chronic obstructive pulmonary disease (COPD), and atherosclerosis is a cause of cardiac comorbidities in COPD. However, it is not clear whether airflow limitation is associated with atherosclerosis irrespective of smoking. OBJECTIVE: To investigate whether airflow limitation is independently associated with vascular stiffness. METHODS: We enrolled 18 893 participants (male 70.5%; mean age 47.5 6 9.8 years; never smokers 44.2%) who underwent spirometry and brachial-ankle pulse wave velocity (baPWV) as part of a standard health examination at Ajou University Hospital, Suwon, South Korea, from January 2010 to December 2015. We defined vascular peripheral atherosclerosis as baPWV ≥ 1400 cm/s and airflow limitation as prebronchodilator ratio of forced expiratory volume in 1 sec (FEV₁) to forced vital capacity (FVC),70%. RESULTS: Mean baPWV was higher in subjects with airflow limitation (1477.6 6 331.7 cm/sec, n ¼ 638) than in those without airflow limitation (1344.1 6 231.8 cm/sec, n ¼ 18255, P, 0.001). In multivariate logistic regression analysis, the following were independent predictors associated with peripheral atherosclerosis (P, 0.05): age, male sex, fasting serum glucose, mean blood pressure, serum leukocyte count, serum low density lipoprotein level and FEV₁. CONCLUSION: Airflow limitation was an independent predictor of vascular stiffness irrespective of smoking history, which suggests that airflow limitation is linked with atherosclerosis.