Objectives: Patients with COPD have increased risk of cardiovascular (CV) events and mortality beyond that attributable to smoking. However, there have been no longitudinal studies of arterial stiffness in COPD. The Assessment of Risk in Chronic Airways Disease Evaluation (ARCADE) aims to study CV risk factors in COPD and controls, free from respiratory disease, longitudinally. We hypothesised that patients with COPD would have increased Aortic pulse wave velocity (AoPWV) over 2 years.

Methods: At baseline, AoPWV was measured using the SphygmoCor device in 525 patients with COPD and 150 controls. Lung function (Forced expiratory volume in 1 second (FEV1) and Forced vital capacity (FVC)), BMI, blood pressure (BP) and systemic inflammation (HsCRP) was also measured. These were repeated after 2 years.

Results: At baseline, patients and controls were similar in age, gender and BMI, but patients had greater PWV, systolic and mean arterial BP, heart rate and HsCRP (all p<0.05). Thus far 200 patients with COPD have completed the 2 year follow-up assessment. Patients had a mean AoPWV increase of 0.5 m/s (95%CI 0.25–0.71, p<0.001), despite no change in central mean arterial BP. In addition, lung function declined (p<0.05) and HsCRP remained high.

Conclusions: The 2 year AoPWV increase in COPD was independent of traditional risk factors suggesting an alternative mechanism for aortic stiffness in COPD. Further longitudinal assessments of a control group will inform the understanding of the development of arterial stiffness and may indicate possible therapeutic targets.