Journal article
Long‐Acting Beta‐Agonist Use is Associated with Lower Carotid Artery Stiffness and Greater Carotid Artery Compliance in Individuals with Chronic Obstructive Pulmonary Disease
The FASEB journal, Vol.32, pp.843.14-843.14
04/2018
DOI: 10.1096/fasebj.2018.32.1_supplement.843.14
Abstract
Background
Cardiovascular disease (CVD) is the most prevalent comorbidity in individuals with chronic obstructive pulmonary disease (COPD). Elevated large elastic artery stiffness (i.e. carotid and aorta) is a robust predictor of CVD events and mortality and is associated with airway obstruction in COPD patients, suggesting that large artery stiffness may contribute, at least in part, to the high CVD risk in COPD. Previous studies demonstrate that in COPD patients, bronchodilator therapy improves respiratory symptoms, lowers the risk of exacerbations and reduces aortic stiffness, as measured by carotid‐femoral pulse wave velocity (CFPWV), in COPD patients with a very high CFPWV (≥ 11 m/s). However, the long‐term benefits of bronchodilator therapy on cardiovascular risk remain controversial. We hypothesized that individuals with COPD who reported using a long‐acting beta‐agonist (LABA) or an inhaled corticosteroid (ICS) would have lower carotid artery stiffness/greater compliance compared with COPD patients not on LABAs or ICSs.
Methods
Sixty‐three adults with COPD (age 70 ± 7 yrs; 23M/40F; GOLD stage 1–4; 6% stage 1, 47% stage 2, 24% stage 3, 23% stage 4) completed measurements of common carotid artery stiffness and compliance (carotid artery ultrasound and tonometry) and were retrospectively stratified by self‐report of LABA and ICS use.
Results
Thirty‐two (49%) participants reported using a LABA/ICS combination bronchodilator. Seven (11%) of patients reported using a LABA alone and 7 (11%) of patients reported using an ICS alone. COPD patients using a LABA/ICS combination bronchodilator had significantly lower carotid β‐stiffness (8.7 ± 0.5 vs. 10.9 ± 0.9 U, P=0.04) and greater carotid compliance (0.11 ± 0.01 vs. 0.08 ± 0.01 mm/mmHg, P=0.01) compared with patients not using a LABA/ICS. This difference remained significant after adjusting for age, gender, BMI, oxygen use and smoking pack‐years (carotid β‐stiffness P=0.04; carotid compliance P=0.05). BP, heart rate and oxygen saturation did not differ between COPD patients using vs. not using a LABA/ICS. Furthermore, patients that reported using a LABA alone, and not in combination with an ICS, had significantly lower carotid β‐stiffness (6.9 ± 0.6 vs. 10.1 ± 0.6 U, P<0.01), but not greater carotid compliance (0.11 ± 0.01 vs. 0.09 ± 0.01 mm/mmHg, P=0.2) compared with those not using a LABA. In contrast, there was no difference in carotid β‐stiffness (9.0 ± 1.2 vs. 9.9 ± 0.6 U, P=0.60) or carotid compliance (0.10 ± 0.01 vs. 0.10 ± 0.01 mm/mmHg, P=0.93) between COPD patients that reported using vs. not using an ICS.
Conclusion
These data indicate that COPD patients who are taking a LABA, either in combination with an ICS or alone, have lower carotid artery stiffness than those not taking a LABA. This finding raises the possibility that LABAs may be beneficial in reducing the CVD risk observed in COPD, however randomized, controlled clinical trials are needed to test whether LABAs impact CVD risk.
Support or Funding Information
NIH K23 HL095658, R01 HL089897, NIH/NCATS CTSI UL1 TR001082
This is from the Experimental Biology 2018 Meeting. There is no full text article associated with this published in The FASEB Journal.
Details
- Title: Subtitle
- Long‐Acting Beta‐Agonist Use is Associated with Lower Carotid Artery Stiffness and Greater Carotid Artery Compliance in Individuals with Chronic Obstructive Pulmonary Disease
- Creators
- Rachel E Luehrs - The University of IowaKerrie L Moreau - The University of ColoradoAlejandro P Comellas - The University of IowaHoward D Weinberger - National Jewish HealthJames D Crapo - National Jewish HealthFrederick Wamboldt - National Jewish HealthKarin F Hoth - The University of IowaGary L Pierce - The University of Iowa
- Resource Type
- Journal article
- Publication Details
- The FASEB journal, Vol.32, pp.843.14-843.14
- Publisher
- The Federation of American Societies for Experimental Biology
- DOI
- 10.1096/fasebj.2018.32.1_supplement.843.14
- ISSN
- 0892-6638
- eISSN
- 1530-6860
- Number of pages
- 1
- Grant note
- NIH/NCATS CTSI (UL1 TR001082) NIH (K23 HL095658; R01 HL089897)
- Language
- English
- Date published
- 04/2018
- Academic Unit
- Internal Medicine; Health and Human Physiology; Psychiatry; Iowa Neuroscience Institute
- Record Identifier
- 9984066138002771
Metrics
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