Blood Pressure Profile and Hypertensive Organ Damage in COPD Patients and Matched Controls. The RETAPOC Study

• Published in: PloS one Vol. 11; no. 6; p. e0157932
• Main Authors: Golpe, Rafael, Mateos-Colino, Alfonso, Testa-Fernández, Ana, Pena-Seijo, Marta, Rodríguez-Enríquez, Manuel, González-Juanatey, Carlos, Martín-Vázquez, Francisco J, Pose-Reino, Antonio, Domínguez-Pin, Nuria, Garnacho-Gayarre, Nuria, Pérez-de-Llano, Luis A
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 30.06.2016; Public Library of Science (PLoS)
• Subjects: Age; Aged; Atherosclerosis; Biology and Life Sciences; Blood; Blood pressure; Blood Pressure - physiology; Blood Pressure Determination; Blood pressure measurement; Cardiology; Cardiovascular disease; Cardiovascular diseases; Cardiovascular Diseases - epidemiology; Case-Control Studies; Catecholamines; Catecholamines - urine; Chronic obstructive lung disease; Chronic obstructive pulmonary disease; Comorbidity; Control methods; Echocardiography; Family medical history; Female; Fibrinogen; Health risks; Hospitals; Humans; Hypertension; Hypertension - complications; Inflammation; Internal medicine; Lung diseases; Male; Medical research; Medicine; Medicine and Health Sciences; Metabolites; Middle Aged; Mortality; Obstructive lung disease; Oximetry; Oxygen; Oxygen content; Patients; Physical Sciences; Plaques; Prospective Studies; Pulmonary Disease, Chronic Obstructive - physiopathology; Research and Analysis Methods; Respiratory diseases; Retina; Retinography; Risk analysis; Risk Factors; Saturation; Smoking; Studies; Sympathetic nervous system; Ultrasound; Ventricle; Germany; Spain
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0157932

Several studies suggest that there is a pathogenic link between chronic obstructive pulmonary disease (COPD) and cardiovascular diseases. On the other hand, increased sympathetic tone has been described in several respiratory diseases. Our objective was to determine whether hypertension mediated by sympathetic overactivity is a mechanism that explains the association between COPD and cardiovascular diseases. Prospective nested case-control observational study; 67 COPD patients were matched 1:1 by sex and age to controls with smoking history. 24 hour-blood pressure monitoring, urinary catecholamines and their metabolites measurement, echocardiography, carotid ultrasound examination, nocturnal oximetry and retinography were performed. classic cardiovascular risk factors and comorbidities were similarly distributed between cases and controls. No significant differences for blood pressure variables (difference for mean systolic blood pressure: -0·13 mmHg; 95% CI: -4·48,4·20; p = 0·94; similar results for all blood presssure variables) or catecholamines values were found between both groups. There was a tendency for lower left ventricle ejection fraction in the COPD cases, that approached statistical significance (64·8 ± 7·4 vs 67·1 ± 6·2, p = 0·05). There were no differences in the retinal arteriovenous ratio, the carotid intima-media thickness, or the number of carotid plaques, between cases and controls. Fibrinogen values were higher in the COPD group (378·4 ± 69·6 vs 352·2 ± 45·6 mg/dL, p = 0·01) and mean nocturnal oxygen saturation values were lower for COPD patients (89·0 ± 4·07 vs 92·3 ± 2·2%, p < 0·0001). Hypertension induced by sympathetic overactivity does not seem to be a mechanism that could explain the association between COPD and cardiovascular disease.