Airflow limitation as a risk factor for vascular stiffness.

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. To investigate whether airflow limitation is independently associated with vascular stiffness. We enrolled 18 893 participants (male 70.5%; mean age 47.5 ± 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 pre-bronchodilator ratio of forced expiratory volume in 1 sec (FEV) to forced vital capacity (FVC) <70%. Mean baPWV was higher in subjects with airflow limitation (1477.6 ± 331.7 cm/sec, = 638) than in those without airflow limitation (1344.1 ± 231.8 cm/sec, = 18255, < 0.001). In multivariate logistic regression analysis, the following were independent predictors associated with peripheral atherosclerosis ( < 0.05): age, male sex, fasting serum glucose, mean blood pressure, serum leukocyte count, serum low density lipoprotein level and FEV. Airflow limitation was an independent predictor of vascular stiffness irrespective of smoking history, which suggests that airflow limitation is linked with atherosclerosis.