Markers of cardiovascular autonomic dysfunction predict COPD in middle-aged subjects

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Ricci, FabrizioLund University,Lunds universitet,Kardiovaskulär forskning - hypertoni,Forskargrupper vid Lunds universitet,Cardiovascular Research - Hypertension,Lund University Research Groups,University G.d'Annunzio of Chieti-Pescara (author)

Markers of cardiovascular autonomic dysfunction predict COPD in middle-aged subjects

Article/chapterEnglish2018

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2018-02-01
European Respiratory Society (ERS),2018

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LIBRIS-ID:oai:lup.lub.lu.se:eeb80d58-0b35-4928-b20b-403b51742233
https://lup.lub.lu.se/record/eeb80d58-0b35-4928-b20b-403b51742233URI
https://doi.org/10.1183/13993003.02481-2017DOI

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Summary in:English

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Autonomic dysfunction is commonly observed in chronic obstructive pulmonary disease (COPD) and may relate to the known comorbidity with coronary artery disease (CAD). We hypothesised that clinical markers of cardiovascular autonomic dysfunction predict COPD in the population, independently of CAD.In a population-based cohort of 24 768 subjects (mean age 45 years) without baseline airflow obstruction, we analysed the cross-sectional relationship of one-minute orthostatic systolic blood pressure (SBP) and diastolic blood pressure (DBP) changes and resting heart rate with forced vital capacity (FVC) and forced expiratory volume in 1 s (FEV1). Cox regression models were used to analyse the association of orthostatic SBP and DBP changes (SBP/DBP decrease) and resting heart rate with incident COPD over a 32-year follow-up.Baseline orthostatic SBP decrease (p=0.020) and DBP decrease (p=0.001) were associated with reduced FVC, whereas resting heart rate was associated with reduced FVC and FEV1 (p<0.001). After adjustment for smoking and baseline lung function, SBP decrease predicted COPD (hazard ratio (HR) 1.10 per 10 mmHg, 95% CI 1.03–1.18). Resting heart rate predicted COPD among smokers (HR 1.11 per 10 beats-per-minute increase, 95% CI 1.05–1.18). Results were similar in subjects without CAD.Subtle signs of cardiovascular autonomic dysfunction may precede the development of COPD in middle-aged subjects. This association is independent of the relationship between cardiovascular autonomic dysfunction and CAD.

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Wollmer, PerLund University,Lunds universitet,Klinisk fysiologi och nuklearmedicin, Malmö,Forskargrupper vid Lunds universitet,Clinical Physiology and Nuclear Medicine, Malmö,Lund University Research Groups,Skåne University Hospital(Swepub:lu)klin-pwo (author)
Engström, GunnarLund University,Lunds universitet,Kardiovaskulär forskning - epidemiologi,Forskargrupper vid Lunds universitet,Cardiovascular Research - Epidemiology,Lund University Research Groups(Swepub:lu)smi-gen (author)
Fedorowski, ArturLund University,Lunds universitet,Kardiovaskulär forskning - hypertoni,Forskargrupper vid Lunds universitet,Cardiovascular Research - Hypertension,Lund University Research Groups,Skåne University Hospital(Swepub:lu)med-afr (author)
Hamrefors, ViktorLund University,Lunds universitet,Kardiovaskulär forskning - hypertoni,Forskargrupper vid Lunds universitet,Cardiovascular Research - Hypertension,Lund University Research Groups,Skåne University Hospital(Swepub:lu)med-vho (author)
Kardiovaskulär forskning - hypertoniForskargrupper vid Lunds universitet (creator_code:org_t)

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In:European Respiratory Journal: European Respiratory Society (ERS)51:31399-30030903-1936

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