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A2162 - History of Cardiovascular Disease and Cardiovascular Risk in People with COPD
Author Block: A. Lemson1, A. Al rajah2, H. Ridsdale3, N. Ochei3, B. Nwaneri3, N. Orr3, J. Brown2, J. Hurst2, Y. Aldabayan2; 1Radboud University, London, United Kingdom, 2UCL Respiratory, Royal Free Campus, University College London, UK, london, United Kingdom, 3Central and North West London NHS Foundation Trust, london, United Kingdom.
Introduction: Cardiovascular disease (CVD) is common in Chronic Obstructive Pulmonary Disease (COPD). Arterial stiffness is proposed as a mechanistic link between COPD and CVD, explained by deteriorating vascular wall structure. Arterial stiffness can be directly measured using aortic Pulse Wave Velocity (aPWV). We hypothesised that because people with COPD are at high-risk of cardiovascular events, there would not be a significant difference in aPWV between this group and those without previous events.
Method: Data were obtained from 43 people with COPD enrolling in a Pulmonary Rehabilitation programme, 12 of which had an existing history of CVD. CVD was defined as heart failure, ischemic heart disease, cerebrovascular disease or peripheral arterial disease. Data was tested for normality and are expressed as either mean (SD) or median (IQR). Depending on distribution, Pearson and Spearman analyses were used to examine correlations. Subgroup comparisons were performed using Chi-square and Mann-Whitney U tests.
Results: 22 male and 21 female subjects with a mean age of 70.5±8.7 years were included. Baseline characteristics were comparable between subgroups, with the exception of reduced FVC% (79.0% vs 88.0%, p=0.045) and elevated diastolic BP (85.77±15.03 vs 75.33±11.11 mmHg, p=0.046) in non-CVD subjects. aPWV was equal in those with and without a history of CVD (10.79 (3.1) vs 10.60 (1.9) m/s, p= 0.787). In the whole group, age was positively correlated with aPWV (rho=0.31, p=0.045), while airflow obstruction (FEV1: rho= -0.364, p=0.018) and depression score (rho= -0,338, p=0.038) were inversely correlated to aPWV. aPWV did not differ by gender in the non-CVD group (male vs female: 10.69 (2.1) vs 10.33 (1.5) m/s; p=0.477), but was significantly increased in male compared to female subjects with existing CVD (12.26±2.63 vs 8.82±2.45 m/s, p=0.019).
Conclusion: We found that arterial stiffness in COPD subjects was similar between those with a known diagnosis of CVD and those without. These data highlight the importance of individualised CV risk assessment in all patients with COPD.