Background
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.
Methods
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.
Results
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.
Conclusions
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.
Abbreviations:
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)Keywords
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Article info
Publication history
Published online: September 30, 2013
Accepted:
August 8,
2013
Received in revised form:
August 7,
2013
Received:
July 25,
2013
Identification
Copyright
© 2013 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier Inc. All rights reserved.
