The Effect of Pulmonary Rehabilitation on Arterial Stiffness in Patients with Chronic Obstructive Pulmonary Disease (COPD)

Background: We have previously shown increased arterial stiffness using aortic pulse wave velocity (PWV) in patients with COPD. Pulmonary rehabilitation (PR) (exercise, education and nutritional advice) has respiratory and functional benefits, though effects on cardiovascular (CV) risk have not been explored. We hypothesised PWV would improve with PR. Methods: 22 (8 male) clinically stable patients, free from overt CV disease had BP, PWV, spirometry (FEV1), shuttle walk (ISWT) and fasting glucose and lipids performed pre and post PR. 20 age and gender matched controls were studied for baseline comparison. Results: Median (range) age for patients was 62.5 (54-79) years, mean (SD) FEV1 was 44.9 (15.6)% predicted. Aortic PWV, cholesterol and BP reduced with PR. 3 of 11 patients no longer met the criteria for hypertension. The fall in aortic PWV was attributable to the fall in BP. Conclusions: PR improves the haemodynamic profile of subjects with COPD. Longer term CV effects of PR should now be investigated