Abstract
BackgroundFindings describing the relationship between pulmonary function and peripheral vascular function have been inconclusive. We explored this relationship in Guangzhou Biobank Cohort Study-Cardiovascular Subcohort (GBCS-CVD).MethodsBrachial-ankle pulse wave velocity (baPWV) and ankle brachial index (ABI) were measured by a waveform analyser, and pulmonary function by turbine flowmeter spirometry. Predicted forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC) were derived using equations for Chinese. Regression analyses were used to investigate the association.ResultsOf 1528 older Chinese, 980 (64.1%) had arterial stiffness (baPWV ≥1400 cm/s), but only 29 (1.9%) had peripheral arterial disease (PAD) (ABI < 0.9). The mean (±standard deviation, SD) baPWV was 1547 (±298) cm/s and mean (±SD) ABI 1.09 (±0.09). Before and after adjusting for potential confounders, baPWV was negatively associated with FEV1 and FVC % predicted (% predicted = observed/predicted × 100%) (adjusted β: − 0.95 and − 1.16 respectively, p < 0.05), and ABI was marginally non-significantly positively associated with FEV1% predicted (adjusted β 0.02, p = 0.32) and FVC% predicted (adjusted β 0.02, p = 0.18). Compared to participants in the highest tertile of pulmonary function, those in the lowest had higher risk of arterial stiffness (adjusted odds ratio (AOR) 1.51, 95% CI 1.09–2.10 for FEV1 and AOR 1.69, 95% CI 1.22–2.33 for FVC), but the higher risk of PAD was marginally non-significant (AOR 1.64, p = 0.42 for FEV1 and AOR 1.65, p = 0.24 for FVC).ConclusionIn older relatively healthy normal weight Chinese, pulmonary function was inversely dose-dependently associated with arterial stiffness, while the association with PAD was much weaker.
Highlights
Findings describing the relationship between pulmonary function and peripheral vascular function have been inconclusive
We found only three studies on the relationship between pulmonary function and vascular function in Asian populations [4, 5, 22] and of them, one was a small hospital-based study (n = 155) in China showing a negative association between brachial-ankle pulse wave velocity (baPWV) and forced expiratory volume in 1 s (FEV1) and FEV1/forced vital capacity (FVC) ratio after adjusting for age, sex, body mass index (BMI) and smoking status [5]
After adjusting for age, sex, education, smoking, physical activity, waist circumference, diastolic blood pressure, triglycerides, fasting plasma glucose, chronic obstructive pulmonary disease (COPD), asthma and medications, the inverse association of baPWV with FEV1% predicted and FVC % predicted remained significant, and that of FEV1 /FVC ratio became non-significant (p = 0.91)
Summary
Findings describing the relationship between pulmonary function and peripheral vascular function have been inconclusive We explored this relationship in Guangzhou Biobank Cohort Study-Cardiovascular Subcohort (GBCS-CVD). Poorer pulmonary function has been reported to be a risk factor for CVD mortality in general population [2], but the mechanisms are unclear. Peripheral vascular dysfunction has been reported to be influenced by many factors including adiposity [17], blood pressure [18], age [18], physical activity [19] and inflammatory biomarkers such as C-reactive protein [20], which are associated with pulmonary function. Three studies examined whether the association varied by smoking status [4, 21] or sex [14, 21]
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