Association between blood pressure, inflammation and spirometry parameters in chronic obstructive pulmonary disease
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Background/Aims: Many systems including the cardiovascular system (ischemic heart diseases, heart failure, and hypertension) may act as comorbidities that can be seen during the course of chronic obstructive pulmonary disease (COPD). Comorbidities affect the severity and prognosis of COPD negatively. Nearly 25% of patients with COPD die due to cardiovascular diseases. In this study, we aimed to evaluate the relationship between the blood pressure, inflammation, hypoxia, hypercapnia, and the severity of airway obstruction. Methods: We included 75 COPD patients in the study with 45 control cases. We evaluated age, sex, body mass index, smoking history, C-reactive protein levels, 24-hour ambulatory blood pressure Holter monitoring, arterial blood gas, and respiratory function tests of the patient and the control groups. Results: In COPD patients, the night time systolic, diastolic blood pressures and pulse per minute and the mean blood pressures readings were significantly elevated compared to the control group (p < 0.05). In the correlation analysis, night time systolic pressure was associated with all the parameters except forced expiratory volume in 1 second (FEV1%). Diastolic blood pressure was associated with pH and HCO3 levels. The mean night time, day time pulse pressures and 24- hour pulse per minute values were also associated with all the parameters except FEV1%. Conclusions: In this study we found that parameters of systolic and diastolic blood pressures and pulse pressures were significantly elevated in COPD patients compared to the control groups. Blood pressure was associated blood gas parameters and inflammation parameters in COPD patients. This, in turn, may cause understanding of the pathophysiology of COPD and its complications.
Abstract
Background/Aims: Many systems including the cardiovascular system (ischemic heart diseases, heart failure, and hypertension) may act as comorbidities that can be seen during the course of chronic obstructive pulmonary disease (COPD). Comorbidities affect the severity and prognosis of COPD negatively. Nearly 25% of patients with COPD die due to cardiovascular diseases. In this study, we aimed to evaluate the relationship between the blood pressure, inflammation, hypoxia, hypercapnia, and the severity of airway obstruction. Methods: We included 75 COPD patients in the study with 45 control cases. We evaluated age, sex, body mass index, smoking history, C-reactive protein levels, 24-hour ambulatory blood pressure Holter monitoring, arterial blood gas, and respiratory function tests of the patient and the control groups. Results: In COPD patients, the night time systolic, diastolic blood pressures and pulse per minute and the mean blood pressures readings were significantly elevated compared to the control group (p < 0.05). In the correlation analysis, night time systolic pressure was associated with all the parameters except forced expiratory volume in 1 second (FEV1%). Diastolic blood pressure was associated with pH and HCO3 levels. The mean night time, day time pulse pressures and 24- hour pulse per minute values were also associated with all the parameters except FEV1%. Conclusions: In this study we found that parameters of systolic and diastolic blood pressures and pulse pressures were significantly elevated in COPD patients compared to the control groups. Blood pressure was associated blood gas parameters and inflammation parameters in COPD patients. This, in turn, may cause understanding of the pathophysiology of COPD and its complications.
참고문헌 (40)
- MacNee W, "Systemic inflammatory biomarkers and co-morbidities of chronic obstructive pulmonary disease", Ann Med, 45, pp.291~300 (2013)
- Dahl M, "C-reactive protein as a predictor of prognosis in chronic obstructive pulmonary disease", Am J Respir Crit Care Med, 175, pp.250~255 (2007)
- de Torres JP, "C-reactive protein levels and clinically important predictive outcomes in stable COPD patients", Eur Respir J, 27, pp.902~907 (2006)
- Barnes PJ, "Systemic manifestations and comorbidities of COPD", Eur Respir J, 33, pp.1165~1185 (2009)
- Vestbo J, "Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease : GOLD executive summary", Am J Respir Crit Care Med, 187, pp.347~365 (2013)
- Sinden NJ, "Chronic obstructive pulmonary disease : an update of treatment related to frequently associated comorbidities", Ther Adv Chronic Dis, 1, pp.43~57 (2010)
- Ghoorah K, "Increased cardiovascular risk in patients with chronic obstructive pulmonary disease and the potential mechanisms linking the two conditions : a review", Cardiol Rev, 21, pp.196~202 (2013)
- de Lucas-Ramos P, "Chronic obstructive pulmonary disease as a cardiovascular risk factor. Results of a case-control study (CONSISTE study)", Int J Chron Obstruct Pulmon Dis, 7, pp.679~686 (2012)
- Jenkins PC, "The relationship between dyspnea and blood pressure in chronic obstructive pulmonary disease", J Cardiovasc Nurs, 22, pp.351~358 (2007)
- Maclay JD, "Cardiovascular risk in chronic obstructive pulmonary disease", Respirology, 12, pp.634~641 (2007)
- Somers VK, "Sleep : a new cardiovascular frontier", N Engl J Med, 353, pp.2070~2073 (2005)
- Cui H, "Prevalence of cardiovascular disease in subjects hospitalized due to chronic obstructive pulmonary disease in Beijing from 2000 to 2010", J Geriatr Cardiol, 9, pp.5~10 (2012)
- Xie A, "Exposure to hypoxia produces long-lasting sympathetic activation in humans", J Appl Physiol(1985), 91, pp.1555~1562 (2001)
- Kannel WB, "Overall and coronary heart disease mortality rates in relation to major risk factors in 325,348 men screened for the MRFIT. Multiple Risk Factor Intervention Trial", Am Heart J, 112, pp.825~836 (1986)
- Alexander RW, "Theodore Cooper Memorial Lecture. Hypertension and the pathogenesis of atherosclerosis. Oxidative stress and the mediation of arterial inflammatory response: a new perspective", Hypertension, 25, pp.155~161 (1995)
- Wan NS, "The effects of chronic intermittent hypoxia on blood pressure and sympathetic nerve activity in rats", Zhonghua Jie He He Hu Xi Za Zhi, 35, pp.29~32 (2012)
- Yasuma F, "Impact of acute hypoxia on heart rate and blood pressure variability in conscious dogs", Am J Physiol Heart Circ Physiol, 279, pp.H2344~H2349 (2000)
- McNicholas WT, "Impact of sleep in COPD", Chest, 117(2 Suppl), pp.48S~53S (2000)
- Kent BD, "Hypoxemia in patients with COPD : cause, effects, and disease progression", Int J Chron Obstruct Pulmon Dis, 6, pp.199~208 (2011)
- Cowburn AS, "Cardiovascular adaptation to hypoxia and the role of peripheral resistance", Elife, 6, pp.e28755~ (2017)
- Stamler J, "Blood pressure (systolic and diastolic) and risk of fatal coronary heart disease", Hypertension, 13(5 Suppl), pp.I2~I12 (1989)
- Ross R, "Atherosclerosis: an inflammatory disease", N Engl J Med, 340, pp.115~126 (1999)
- Fabbri LM, "From COPD to chronic systemic inflammatory syndrome?", Lancet, 370, pp.797~799 (2007)
- Schols AM, "Evidence for a relation between metabolic derangements and increased levels of inflammatory mediators in a subgroup of patients with chronic obstructive pulmonary disease", Thorax, 51, pp.819~824 (1996)
- Gan WQ, "Association between chronic obstructive pulmonary disease and systemic inflammation : a systematic review and a meta-analysis", Thorax, 59, pp.574~580 (2004)
- Palange P, "Circulating haemopoietic and endothelial progenitor cells are decreased in COPD", Eur Respir J, 27, pp.529~541 (2006)
- Lattimore JD, "Repetitive hypoxia increases lipid loading in human macrophages-a potentially atherogenic effect", Atherosclerosis, 179, pp.255~259 (2005)
- Hartmann G, "High altitude increases circulating interleukin-6, interleukin-1 receptor antagonist and C-reactive protein", Cytokine, 12, pp.246~252 (2000)
- Savransky V, "Chronic intermittent hypoxia induces atherosclerosis", Am J Respir Crit Care Med, 175, pp.1290~1297 (2007)
- Chen L, "Oxidative stress and left ventricular function with chronic intermittent hypoxia in rats", Am J Respir Crit Care Med, 172, pp.915~920 (2005)
- Pepys MB, "C-reactive protein : a critical update", J Clin Invest, 111, pp.1805~1812 (2003)
- Sin DD, "Effects of fluticasone on systemic markers of inflammation in chronic obstructive pulmonary disease", Am J Respir Crit Care Med, 170, pp.760~765 (2004)
- Pinto-Plata VM, "C-reactive protein in patients with COPD, control smokers and non-smokers", Thorax, 61, pp.23~28 (2006)
- Fichtlscherer S, "Elevated C-reactive protein levels and impaired endothelial vasoreactivity in patients with coronary artery disease", Circulation, 102, pp.1000~1006 (2000)
- Jialal I, "Inflammation and atherosclerosis: the value of the high-sensitivity C-reactive protein assay as a risk marker", Am J Clin Pathol, (116 Suppl), pp.S108~S115 (2001)
- Dodson PM, "Retinal vein occlusion : C-reactive protein and arterial hypertension", Acta Ophthalmol(Copenh), 62, pp.123~130 (1984)
- De Haro J, "Relationship between the plasma concentration of C-reactive protein and severity of peripheral arterial disease", Clin Med Cardiol, 3, pp.1~7 (2008)
- Gan WQ, "The interactions between cigarette smoking and reduced lung function on systemic inflammation", Chest, 127, pp.558~564 (2005)
- Fan W, "Association of lung function and chronic obstructive pulmonary disease with American Heart Association's Life's Simple 7 cardiovascular health metrics", Respir Med, 131, pp.85~93 (2017)
- Schunemann HJ, "Pulmonary function is a long-term predictor of mortality in the general population : 29-year follow-up of the Buffalo Health Study", Chest, 118, pp.656~664 (2000)