Related Experiment Video
Updated: Jan 2, 2026
Generation of a Chronic Obstructive Pulmonary Disease Model in Mice by Repeated Ozone Exposure
Published on: August 25, 2017
Chronic Obstructive Pulmonary Disease as a Predictor of Cardiovascular Risk: A Case-Control Study
Mohammed Y Khanji1,2, Ian S Stone1,2, Redha Boubertakh1,2
1Centre for Advanced Cardiovascular Imaging, NIHR Barts Biomedical Research Centre, William Harvey Research Institute, Queen Mary University London, London, UK.
Insights
Chronic obstructive pulmonary disease (COPD) adversely affects arterial stiffness, increasing cardiovascular event risk. Incorporating COPD into risk models may improve prediction for better patient management.
Area of Science:
- Cardiology
- Pulmonology
- Medical Research
Background:
- Chronic obstructive pulmonary disease (COPD) is linked to increased cardiac mortality.
- Current cardiovascular risk prediction models do not account for COPD.
- COPD's impact on cardiovascular risk requires further investigation.
Purpose of the Study:
- To investigate if COPD modifies future cardiovascular risk.
- To determine if COPD should be included in cardiovascular risk prediction models.
Main Methods:
- A case-control study utilizing data from two randomized controlled trials (2012-2015).
- Propensity matching of 26 COPD patients with lung hyperinflation to 26 controls based on 10-year global cardiovascular risk score (QRISK2).
- Measurements included cardiac MRI, arterial stiffness (pulse wave velocity, total arterial compliance, aortic distensibility), and lung function.
Main Results:
- COPD patients exhibited significantly higher pulse wave velocity (PWV) and lower total arterial compliance (TAC) compared to controls.
- The observed PWV difference suggests a 14-15% increase in relative risk for cardiovascular events and mortality.
- QRISK2 and PWV relationship was modified by COPD, indicating an interaction effect.
Conclusions:
- Cardiovascular outcome markers are negatively impacted in COPD patients with lung hyperinflation.
- Cardiovascular risk algorithms could be enhanced by including a COPD variable for improved risk prediction.
- This inclusion may aid in guiding management strategies for COPD patients.
Abstract:
Chronic obstructive pulmonary disease (COPD) is a complex multi-morbid disorder with significant cardiac mortality. Current cardiovascular risk prediction models do not include COPD. We investigated whether COPD modifies future cardiovascular risk to determine if it should be considered in risk prediction models.Case-control study using baseline data from two randomized controlled trials performed between 2012 and 2015. Of the 90 eligible subjects, 26 COPD patients with lung hyperinflation were propensity matched for 10-year global cardiovascular risk score (QRISK2) with 26 controls having normal lung function. Patients underwent cardiac magnetic resonance imaging, arterial stiffness and lung function measurements. Differences in pulse wave velocity (PWV), total arterial compliance (TAC) and aortic distensibility were main outcome measures.PWV (mean difference 1.0 m/s, 95% CI 0.02-1.92; p = 0.033) and TAC (mean difference -0.27 mL/m2/mmHg, 95% CI 0.39-0.15; p < 0.001) were adversely affected in COPD compared to the control group. The PWV difference equates to an age, sex and risk-factor adjusted increase in relative risk of cardiovascular events and mortality of 14% and 15%, respectively.There were no differences in aortic distensibility. In the whole cohort (n = 90) QRISK2 (β = 0.045, p = 0.005) was associated with PWV in multivariate analysis. The relationship between QRISK2 and PWV were modified by COPD, where the interaction term reached significance (p = 0.014). FEV1 (β = 0.055 (0.027), p = 0.041) and pulse (B = -0.006 (0.002), p = 0.003) were associated with TAC in multivariate analysis.Markers of cardiovascular outcomes are adversely affected in COPD patients with lung hyperinflation compared to controls matched for global cardiovascular risk. Cardiovascular risk algorithms may benefit from the addition of a COPD variable to improve risk prediction and guide management.HAPPY London ClinicalTrials.gov: NCT01911910 and HZC116601; ClinicalTrials.gov: NCT01691885.
Related Concept Videos
01:20Chronic Obstructive Pulmonary Disease-I: Introduction
01:22Chronic Obstructive Pulmonary Disease
Smoking is a primary risk factor for COPD, with over 80% of patients having a history of it. Patients typically experience progressive dyspnea or labored breathing, frequent coughing, and recurrent pulmonary infections. Many eventually succumb to respiratory failure, characterized by...
01:27Chronic Obstructive Pulmonary Disease-IV: Assessement and Diagnostic Studies
Medical History
01:25Chronic Obstructive Pulmonary Disease-III: Symptoms and Complications.
Symptoms of COPD can be classified as primary or systemic. Primary symptoms relate to reduced airflow, while systemic or extrapulmonary symptoms relate to COPD's broader impact on the body.
Primary Symptoms of COPD:
01:20Chronic Obstructive Pulmonary Disease-II: Pathophysiology
Chronic Inflammation
01:20COPD: Pathogenesis and Clinical Features
The primary cause for the onset of COPD is cigarette smoking and exposure to air pollution. These hazardous factors initiate a chain reaction within the lungs, resulting in chronic inflammation, damage to the airways, and a...