Arterial Stiffness and Osteoporosis in Chronic Obstructive Pulmonary Disease

Sabit, Ramsey; Bolton, Charlotte E.; Edwards, P.; Pettit, Rebecca; Evans, W. D.; McEniery, Carmel M.; Wilkinson, Ian B.; Cockcroft, John R.; Shale, Dennis J.

doi:10.1164/rccm.200701-067oc

Cited by 346 publications

(373 citation statements)

References 53 publications

(66 reference statements)

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“…Using computed tomography (CT) to determine bone density of thoracic vertebrae, there is a significant correlation between CT-measured emphysema and bone density, supporting the view that osteoporosis is related to emphysema [126]. There is some evidence that osteoporosis is also associated with an increased risk of atherosclerosis and heart disease in patients without COPD [109]. The association between osteoporosis and increased arterial wall stiffness as well as between these variables and the systemic level of IL-6 suggests a common association with the degree of systemic inflammation.…”

Section: Osteoporosismentioning

confidence: 95%

“…Arterial stiffness is increased in patients with COPD compared with normal smokers and nonsmokers and is unrelated to disease severity or circulating CRP concentrations [109,110]. The increased arterial stiffness may predispose patients to systemic hypertension and an increased risk of cardiovascular disease in COPD patients [111].…”

Section: Arterial Stiffness and Endothelial Functionmentioning

confidence: 99%

See 1 more Smart Citation

Systemic manifestations and comorbidities of COPD

Barnes¹,

Celli²

2009

European Respiratory Journal

1,444

1,113

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Increasing evidence indicates that chronic obstructive pulmonary disease (COPD) is a complex disease involving more than airflow obstruction. Airflow obstruction has profound effects on cardiac function and gas exchange with systemic consequences. In addition, as COPD results from inflammation and/or alterations in repair mechanisms, the ''spill-over'' of inflammatory mediators into the circulation may result in important systemic manifestations of the disease, such as skeletal muscle wasting and cachexia. Systemic inflammation may also initiate or worsen comorbid diseases, such as ischaemic heart disease, heart failure, osteoporosis, normocytic anaemia, lung cancer, depression and diabetes. Comorbid diseases potentiate the morbidity of COPD, leading to increased hospitalisations, mortality and healthcare costs. Comorbidities complicate the management of COPD and need to be evaluated carefully. Current therapies for comorbid diseases, such as statins and peroxisome proliferator-activated receptor-agonists, may provide unexpected benefits for COPD patients. Treatment of COPD inflammation may concomitantly treat systemic inflammation and associated comorbidities. However, new broad-spectrum anti-inflammatory treatments, such as phosphodiesterase 4 inhibitors, have significant side-effects so it may be necessary to develop inhaled drugs in the future. Another approach is the reversal of corticosteroid resistance, for example with effective antioxidants. More research is needed on COPD comorbidities and their treatment.

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Section: Osteoporosismentioning

confidence: 95%

Section: Arterial Stiffness and Endothelial Functionmentioning

confidence: 99%

Systemic manifestations and comorbidities of COPD

Barnes¹,

Celli²

2009

European Respiratory Journal

1,444

1,113

View full text Add to dashboard Cite

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“…Patients with COPD present vessels with increased arterial stiffness [96]; the vessels are less elastic and correlate with disease severity [120], probably due to altered ECM structure [121]. The systemic inflammation may affect elasticity in the pulmonary vessels and C -reactive protein (CRP; high levels indicate infection or inflammation) in serum correlate positively with arterial stiffness [122].…”

Section: Vascular Changes and Growth Factors In Copdmentioning

confidence: 99%

Pulmonary vascular changes in asthma and COPD

Harkness

Kanabar

Sharma

et al. 2014

Pulmonary Pharmacology & Therapeutics

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In chronic lung disorders such as in asthma and chronic obstructive pulmonary disease (COPD) there is increased bronchial angiogenesis and remodelling of pulmonary vessels culminating to altered bronchial and pulmonary circulation. The involvement of residential cells such as endothelial cells, smooth muscle cells and pulmonary fibroblasts, all appear to have a crucial role in the progression of vascular inflammation and remodelling. The regulatory abnormalities, growth factors and mediators implicated in the pulmonary vascular changes of asthma and COPD subjects and potential therapeutic targets have been described in this review.

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“…The prevalence of low bone mineral density (BMD) is higher in COPD than control subjects at 40-70% depending on the study population, and is related to disease severity, CT-quantified emphysema score, arterial stiffness, systemic inflammatory markers, BMI and physical activity [76][77][78]. Although low BMD is more common in female COPD patients, strikingly, males are also at high risk.…”

Section: Low Bone Mineral Density and Fracture Riskmentioning

confidence: 99%