Heart, Lung and Circulation
Original Article| Volume 23, ISSUE 3, P280-286, March 2014

The Speed of Blood Pressure Fluctuations in Patients with Chronic Obstructive Pulmonary Disease

Published:September 30, 2013DOI:


      Chronic obstructive pulmonary disease (COPD) has been associated with increased risk for cardiovascular disease but mechanisms underlying this association are incompletely understood. The speed of beat-to-beat changes in systolic blood pressure (vSBP) was found to be pronounced in patients with elevated cardiovascular risk. Although increased vSBP may thus be a contributing mechanism to cardiovascular morbidity, no data exist on vSBP in patients with COPD. Therefore, the purpose of this study was to evaluate whether there is an association between severity of COPD and vSBP.


      Resting beat-to-beat blood pressure was recorded during 5 min. vSBP was assessed by calculating the slopes of oscillatory fluctuations in SBP for different inter-beat intervals (IBI). Univariate and multivariate analyses were performed to evaluate the association between forced expiratory volume in 1 s (FEV1) and vSBP.


      This study comprised 60 patients with COPD (24 females) with a mean [SD] FEV1 of 45.4 [22.7] %predicted and 34 healthy controls. Short-term fluctuations in SBP were more pronounced in patients with COPD compared to healthy controls. There was a significant inverse correlation between FEV1 and vSBP (r = −0.41, p = 0.001). Even after adjustment for covariates in multivariate analysis, FEV1 was found to be independently associated with vSBP.


      Patients with COPD are characterised by steeper blood pressure changes than healthy controls. The speed of fluctuations in SBP is associated with the severity of airflow limitation. Increased vSBP may be a mechanism underpinning the association between COPD and cardiovascular disease.


      ATS (American Thoracic Society), BMI (body mass index), BPV (blood pressure variability), COPD (chronic obstructive pulmonary disease), DLCO (diffusion capacity for carbon monoxide), ERS (European Respiratory Society), FEV1 (forced expiratory volume in 1s), HF power (high-frequency spectral power), HR (heart rate), IBI (inter-beat intervals), LF power (low-frequency spectral power), Mean-SBP (mean of the SBP values), PaCO2 (partial pressure of carbon dioxide), PaO2 (partial pressure of oxygen), rMSSD-SBP (the root mean square successive differences of SBP), RV/TLC (residual volume/total lung capacity ratio), SBP (systolic blood pressure), SD-SBP (SD of SBP values), vSBP (the speed of changes in SBP)


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