Restrictive Spirometry Pattern Predictive of Arterial Stiffness

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The gold standard for measuring arterial stiffness is carotid-femoral pulse wave velocity.
The gold standard for measuring arterial stiffness is carotid-femoral pulse wave velocity.

Restrictive spirometry pattern and reduced forced vital capacity (FVC) are associated with a higher risk for arterial stiffness regardless of sex, according to research published in Chest.

I-Hsuan Wu, MD, from the National Cheng Kung University and Hospital in Tainan, Taiwan, and colleagues sought to determine whether there were any sex differences between restrictive spirometry patterns and arterial stiffness. Previous studies had almost exclusively examined men.

 

The study included 2961 participants (1709 men and 1252 women; mean age: 45.3±11.3 and 44.8±11.2 years, respectively). Participants with obstructive lung disease, history of asthma, cardiopulmonary diseases, or stroke and those taking medications that would influence blood pressure, plasma glucose, or pulmonary function tests were excluded. The researchers defined restrictive spirometry pattern as a FVC <80% of the predicted value and forced expiratory volume in 1 second (FEV1)/FVC ratio ≥70%. Increased arterial stiffness was determined by right brachial ankle pulse wave velocity ≥1400 cm/second.

In both men and women, restrictive spirometry pattern was positively associated with increased arterial stiffness (unadjusted odds ratio [OR], 3.29 [95% CI, 2.26-4.80] and OR, 4.51 [95% CI, 2.97-6.86], respectively). In the adjusted model, age, systolic blood pressure, and restrictive spirometry pattern were also positively associated with increased arterial stiffness.

Despite similar findings, there were some sex differences. Researchers found a positive association with total cholesterol and increased arterial stiffness in women (OR, 1.01; 95% CI, 0.99-1.01) and with current smoking and increased arterial stiffness in men (OR, 1.49; 95% CI, 1.07-2.08).

Because of the positive associations among restrictive spirometry pattern, reduced FVC, and increased arterial stiffness in both men and women, the researchers suggest "assessment and follow-up of arterial stiffness might thus be considered in individuals with restrictive spirometry pattern."

Study Limitations

  • Patient selection may not be representative of other ethnicities, as it included Taiwanese patients who volunteer for medical checkups.
  • Because this was a cross-sectional study, it is not possible to draw conclusions about the causality between restrictive lung disease and arterial stiffness.

Reference

Wu IH, Sun ZJ, Lu FH, et al. Restrictive spirometry pattern is associated with increased arterial stiffness in men and women [published online April 13, 2017]. Chest. doi: 10.1016/j.chest.2017.03.039

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