The framingham risk score in chronic obstructive pulmonary disease (COPD)

Patients with chronic obstructive pulmonary disease (COPD) have increased risk of cardiovascular (CV) events and mortality beyond that attributable to smoking. Although identifying CV risk in COPD is difficult, aortic pulse wave velocity (aPWV), a validated measure of arterial stiffness and an independent predictor of cardiovascular (CV) outcomes, is elevated in patients with COPD. We hypothesised that patients with COPD would have greater Framingham risk score and aPWV than controls and that aPWV would relate to Framingham risk score. Methods At baseline 524 patients with COPD and 143 controls (free from lung disease) were assessed for; lung function (forced expiratory volume (FEV1), forced vital capacity (FVC) and their ratio), blood pressure (BP), BMI, aPWV and blood pressure (BP). In addition, medical and smoking history were recorded and used to calculate the Framingham risk score and vascular age. Results Patients and controls were similar in age, gender and BMI, but patients had greater aPWV, Framingham risk score and vascular age (Table 1), which remained after adjustment for age, and MAP. In COPD, Framingham risk related to age r=0.295, aPWV r=2.34, SBP r=0.194 and FEV1% predicted r=0.112, (all p<0.01). In controls, Framingham risk score related only to age r=383, aPWV r=0.189 and systolic BP r=0.195 p<0.05. Conclusions The association between the Framingham risk score and aPWV suggests that either may be useful to identify individuals with COPD at risk of future CV events. The presence of increased vascular age which related to aPWV suggests that patients with COPD may have premature vascular aging which may explain the excess CV risk. Further follow-up of this cohort will evaluate the prognostic utility of these measures of CV risk.