Assessment of arterial stiffness in stable patients of chronic obstructive pulmonary disease: a prospective case control study


  • Sandeep Kumar Department of Pharmacology, I.G.M.C., Shimla, Himachal Pradesh, India
  • D. D. Gupta Department of Pharmacology, I.G.M.C., Shimla, Himachal Pradesh, India
  • Malay Sarkar Department of Pulmonary Medicine, I.G.M.C., Shimla, Himachal Pradesh, India
  • Ramesh . Department of Pharmacology, I.G.M.C., Shimla, Himachal Pradesh, India



Arterial stiffness, COPD, Periscope analysis


Background: Chronic obstructive pulmonary disease (COPD) is a major cause of morbidity and mortality worldwide and represents a substantial socioeconomic burden. Co-morbidities are more in COPD patients. Cardiovascular disease is one of the co-morbid conditions in COPD. Arterial stiffness has a strong predictive value for cardiovascular events, which can be assessed non-invasively. Various predictors of arterial stiffness between stable COPD patients and healthy volunteers were measured and compared.

Methods: COPD patients attending pulmonary medicine outpatient services were screened for enrolment. It was a prospective case control study with enrolment of fifty COPD stable cases and fifty healthy control, who were matched for their age and sex. All eligible participants were subjected to focused history and physical examination as per structured questionnaire, followed by spirometric examination, periscope test, arterial blood gas analysis and six- minute walk test (6MWT).

Results: Increased arterial stiffness was observed in COPD patients over a wide range of severity of airway obstruction. Distance walked in 6MWT and spirometric values were significantly lower in COPD group as compared to healthy group.

Conclusions: It was concluded that vascular changes, which are predictive of cardiovascular disease remain as cardiovascular risks in mild or early lung disease. A strong relationship between COPD, systemic inflammation, arterial stiffness and cardiovascular disease had been found which needs to be explored further. It was finally concluded that targeted therapeutic approach has broad aspect in reducing cardiovascular risks and has potential for improved prognosis in COPD.


Global Strategy for the Diagnosis, Management and Prevention of COPD. Global Initiative for Chronic Obstructive Lung Disease (GOLD); 2017. Available at: Accessed March 15, 2017.

Lozano R, Naghavi M, Foreman K, Lim S, Shibuya K, Aboyans V, et al. Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2012 Dec 15;380(9859):2095-128.

Mannino DM, Thorn D, Swensen A, Holguin F. Prevalence and outcomes of diabetes, hypertension, and cardiovascular disease in chronic obstructive pulmonary disease. European Resp J. 2008 Jun 25.

Divo M, Cote C, de Torres JP, Casanova C, Marin JM, Pinto-Plata V, et al. Comorbidities and risk of mortality in patients with chronic obstructive pulmonary disease. Am J Resp Critical Care Med. 2012 Jul 15;186(2):155-61.

Lange P, Mogelvang R, Marott JL, Vestbo J, Jensen JS. Cardiovascular morbidity in COPD: a study of the general population. COPD. J Chronic Obstructive Pulmonary Dis. 2011 Feb 1;7(1):5-10.

McAllister DA, Maclay JD, Mills NL, Mair G, Miller J, Anderson D, et al. Arterial stiffness is independently associated with emphysema severity in patients with chronic obstructive pulmonary disease. Am J Resp Critical Care Med. 2007 Dec 15;176(12):1208-14.

Laurent S, Alivon M, Beaussier H, Boutouyrie P. Aortic stiffness as a tissue biomarker for predicting future cardiovascular events in asymptomatic hypertensive subjects. Ann Med. 2012 Jun 1;44(sup1):S93-7.

Sabit R, Bolton CE, Edwards PH, Pettit RJ, Evans WD, McEniery CM, et al. Arterial stiffness and osteoporosis in chronic obstructive pulmonary disease. Am J Resp Critical Care Med. 2007 Jun 15;175(12):1259-65.

Yeboah J, McClelland RL, Polonsky TS, Burke GL, Sibley CT, O’leary D, et al. Comparison of novel risk markers for improvement in cardiovascular risk assessment in intermediate-risk individuals. JAMA. 2012 Aug 22;308(8):788-95.

Sweileh WM. A prospective comparative study of gentamicin and Amikacin induced nephrotoxicity in patients with normal baseline renal function. Fundam Clin Pharmacol. 2009;23(4):515-20.

van Popele NM, Grobbee DE, Bots ML, Asmar R, Topouchian J, Reneman RS, et al. Association between arterial stiffness and atherosclerosis: the Rotterdam Study. Stroke. 2001 Feb;32(2):454-60.

Vivodtzev I, Minet C, Wuyam B, Borel JC, Vottero G, Monneret D, et al. Significant improvement in arterial stiffness after endurance training in patients with COPD. Chest. 2010 Mar 1;137(3):585-92.

Butland RJ, Pang JA, Gross ER, Woodcock AA, Geddes DM. Two-, six-, and 12-minute walking tests in respiratory disease. Br Med J (Clinical research ed.). 1982 May 29;284(6329):1607.

Kumar S, Muniyandi M, Kumar D, Pandey M, Soan V, Rajasubramaniam S. Chronic Obstructive Pulmonary Disease: Understanding and Promoting Healthy Lifestyle among Gond Tribe in Madhya Pradesh, India. Int J Curr Microbiol App Sci. 2016;5(10):27-32.

Jindal SK, Aggarwal AN, Gupta D. Disease and its association with smoking. Indian J Chest Dis Allied Sci. 2001;43:139-471.

Jindal SK, Aggarwal AN, Chaudhry K, Chhabra SK, D Souza GA, Gupta D, et al. A multicentric study on epidemiology of chronic obstructive pulmonary disease and its relationship with tobacco smoking and environmental tobacco smoke exposure. Indian J Chest Dis Allied Sci. 2006 Jan;48(1):23.

Jensen MT, Marott JL, Lange P, Vestbo J, Schnohr P, Nielsen OW, et al. Resting heart rate is a predictor of mortality in COPD. European Resp J. 2013 Aug 1;42(2):341-9.

Janner JH, McAllister DA, Godtfredsen NS, Prescott E, Vestbo J. Is chronic obstructive pulmonary disease associatedwith increased arterial stiffness? Resp Med. 2012;106:397-405.

Sin DD, Wu L, Man SP. The relationship between reduced lung function and cardiovascular mortality: a population-based study and a systematic review of the literature. Chest. 2005 Jun 1;127(6):1952-9.

Kool MJ, Hoeks AP, Boudier HA, Reneman RS, Van Bortel LM. Short and long-term effects of smoking on arterial wall properties in habitual smokers. J Am Coll Cardiol. 1993 Dec 1;22(7):1881-6.

Failla M, Grappiolo A, Carugo S, Calchera I, Giannattasio C, Mancia G. Effects of cigarette smoking on carotid and radial artery distensibility. J Hypertension. 1997 Dec 1;15(12):1659-64.

Hartmann G, Tschöp M, Fischer R, Bidlingmaier C, Riepl R, Tschöp K, et al. High altitude increases circulating interleukin-6, interleukin-1 receptor antagonist and C-reactive protein. Cytokine. 2000 Mar 1;12(3):246-52.

Cinarka H, Kayhan S, Gumus A, Durakoglugil ME, Erdogan T, Ezberci I, et al. Arterial stiffness measured via carotid femoral pulse wave velocity is associated with disease severity in COPD. Respiratory Care. 2014 Feb 1;59(2):274-80.

Camillo CA, Pitta F, Possani HV. Heart rate variability and disease characteristics in patients with COPD. Lung. 2008;186(6):393-401.

Zureik M, Benetos A, Neukirch C, Courbon D, Bean K, Thomas F, et al. Reduced pulmonary function is associated with central arterial stiffness in men. Am J Resp Critical Care Med. 2001 Dec 15;164(12):2181-5.

Iwamoto H, Yokoyama A, Kitahara Y, Ishikawa N, Haruta Y, Yamane K, et al. Airflow limitation in smokers is associated with subclinical atherosclerosis. Am J Resp Critical Care Med. 2009 Jan 1;179(1):35-40.

Barr RG, Ahmed FS, Carr JJ, Hoffman EA, Jiang R, Kawut SM, et al. Subclinical atherosclerosis, airflow obstruction and emphysema: the MESA lung study. Eur Resp J. 2012 Apr 1;39(4):846-54.

Schroeder EB, Welch VL, Evans GW, Heiss G. Impaired lung function and subclinical atherosclerosis: the ARIC study. Atherosclerosis. 2005 Jun 1;180(2):367-73.

Miyamoto S, Nagaya N, Satoh T, Kyotani S, Sakamaki F, Fujita M, et al. Clinical correlates and prognostic significance of six-minute walk test in patients with primary pulmonary hypertension: comparison with cardiopulmonary exercise testing. Am J Resp Critical Care Med. 2000 Feb 1;161(2):487-92.

Britto RR, Probst VS, Andrade AF, Samora GA, Hernandes NA, Marinho PE, et al. Reference equations for the six-minute walk distance based on a Brazilian multicenter study. Brazilian J Physical Therapy. 2013 Dec;17(6):556-63.




How to Cite

Kumar, S., Gupta, D. D., Sarkar, M., & ., R. (2018). Assessment of arterial stiffness in stable patients of chronic obstructive pulmonary disease: a prospective case control study. International Journal of Basic & Clinical Pharmacology, 7(11), 2078–2085.



Original Research Articles