Premature vascular ageing in cystic fibrosis

Abstract

It is increasingly recognised that chronic inflammatory disorders of the lungs, such as chronic obstructive pulmonary disease (COPD), and other organs, such as rheumatoid arthritis, are associated with systemic effects that result in comorbidities 1, 2. Cystic fibrosis (CF) has also been shown to have systemic effects, for example loss of muscle mass and decreased bone density associated with a systemic inflammatory response 3. A further systemic effect of chronic inflammatory conditions, such as COPD and rheumatoid arthritis, is the development of systemic vascular abnormalities with resultant cardiovascular comorbidity 4, 5, which has important adverse effects on morbidity and mortality in these conditions. Many of these comorbid conditions are a feature of ageing, and it has been suggested that the presence of these comorbidities reflects an accelerated ageing process in conditions such as COPD 6. Increased central arterial stiffening is a hallmark of the ageing process even in healthy individuals without any cardiovascular disease 7, and is a consequence in many disease states, such as diabetes, arteriosclerosis, chronic renal impairment 8 and COPD 9. Arterial stiffening is also a marker of increased cardiovascular risk, including myocardial infarction, heart failure and total mortality 10. There is very little clinical or epidemiological data linking increased cardiovascular risk in CF patients, perhaps due to the shortened lifespan in these patients or to protection against the development of cardiovascular disease due to a favourable lipid and blood pressure profile in these patients 11. In this issue of the European Respiratory Journal , Hull et al. 12 …