Related Experiment Video
Updated: May 31, 2026
Measuring the Carotid to Femoral Pulse Wave Velocity (Cf-PWV) to Evaluate Arterial Stiffness
Published on: May 3, 2018
Effect of fluticasone propionate/salmeterol on arterial stiffness in patients with COPD
Mark T Dransfield1, John R Cockcroft, Raymond R Townsend
1University of Alabama Birmingham Lung Health Center, University of Alabama at Birmingham, The Birmingham VA Medical Center, Birmingham, AL, USA. mdransfield99@msn.com
Insights
Fluticasone propionate/salmeterol (FSC) did not significantly reduce arterial stiffness in all patients with chronic obstructive pulmonary disease (COPD). However, FSC may benefit COPD patients with higher baseline arterial stiffness.
Area of Science:
- Cardiology
- Pulmonology
- Pharmacology
Background:
- Chronic obstructive pulmonary disease (COPD) is linked to increased arterial stiffness, potentially explaining its associated cardiovascular morbidity.
- A direct causal link between arterial stiffness and cardiovascular events in COPD remains unestablished.
- Therapies reducing arterial stiffness may improve cardiovascular outcomes in COPD patients.
Purpose of the Study:
- To investigate the effect of fluticasone propionate/salmeterol (FSC) on arterial stiffness in patients with moderate to severe COPD.
- To determine if FSC can reduce aortic pulse wave velocity (aPWV) in this patient population.
Main Methods:
- A multicenter, randomized, double-blind, placebo-controlled study.
- Compared FSC 250/50 μg twice-daily versus placebo over 12 weeks.
- Measured changes in aortic pulse wave velocity (aPWV) from baseline.
Main Results:
- No statistically significant reduction in aPWV was observed between FSC and placebo groups overall (p = 0.065).
- A significant reduction in aPWV was noted in patients who completed the full 12-week treatment period (p = 0.045).
- Post hoc analysis indicated a potentially greater effect of FSC in patients with higher baseline aPWV.
Conclusions:
- FSC does not uniformly reduce arterial stiffness in all moderate to severe COPD patients.
- FSC may offer benefits for COPD patients with elevated arterial stiffness.
- Further research is needed to confirm aPWV as a surrogate marker for cardiovascular events in COPD.
Background:
COPD is associated with increased arterial stiffness which may in part explain the cardiovascular morbidity observed in the disease. A causal relationship between arterial stiffness and cardiovascular events has not been established, though their strong association raises the possibility that therapies that reduce arterial stiffness may improve cardiovascular outcomes. Prior studies suggest that fluticasone propionate/salmeterol (FSC) may improve cardiovascular outcomes in COPD and we hypothesized that FSC would reduce arterial stiffness in these patients.
Methods:
This multicenter, randomized, double-blind, placebo-controlled study compared the effects of FSC 250/50 μg twice-daily and placebo on aortic pulse wave velocity (aPWV) as determined by ECG-gated carotid and femoral artery waveforms. The primary endpoint was aPWV change from baseline at 12-weeks (last measure for each patient).
Results:
249 patients were randomized; the mean FEV(1) in each group was similar (55% predicted) and 60% of patients reported a cardiovascular disorder. At 12-weeks, aPWV between FSC and placebo was -0.42 m/s (95%CI -0.88, 0.03; p = 0.065). A statistically significant reduction in aPWV between FSC and placebo was observed in those who remained on study drug throughout the treatment period [-0.49 m/s (95%CI -0.98, -0.01; p = 0.045)]. A post hoc analysis suggested the effect of FSC was greater in patients with higher baseline aPWV.
Conclusion:
FSC does not reduce aPWV in all patients with moderate to severe COPD, but may have effects in those with elevated arterial stiffness. Additional studies are required to determine if aPWV could serve as a surrogate for cardiovascular events in COPD.
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