Background: Male patients with chronic obstructive pulmonary disease (COPD) are at greater risk of cardiovascular (CV) events than females¹. Aortic stiffness is an independent predictor of adverse CV outcomes and elevated in COPD². However, the influence of gender on aortic stiffness in COPD has not been established. We hypothesized that males with COPD would have greater aortic stiffness than females.

Methods: As part of the ARCADE study, we assessed 500 patients with COPD confirmed by spirometry and 150 comparators. Aortic pulse wave velocity (PWV) was evaluated using the sphygmoCor device. Other assessments included body composition, blood pressure, heart rate, number of exacerbations, smoking history and C-reactive protein and fibrinogen.

Results: Patients and comparators were similar in age, BMI and gender. Males with COPD (255) had greater aortic PWV mean (SD)10.2 (2.7) than females,9.5 (2.4), p=0.003. However, they were similar in age, FEV₁%, BMI, peripheral and central blood pressure indices, heart rate, number of exacerbations, smoking history and inflammatory biomarkers, p>0.05. The difference remained after controlling for age and peripheral mean arterial pressure (Adjusted R²=26%, F=6.15, p=0.014). The gender difference was not evident in the comparator group.

Conclusion: Males with COPD had greater aortic stiffness compared to the females, independent of traditional cardiovascular risk factors. The increased aortic stiffness may explain the high incidence of fatal and non-fatal cardiac events in the male patients, which may offer a therapeutic target.