The Relationship between Peripheral Arterial Disease and Chronic Obstructive Pulmonary Disease.
Smoking-induced inflammation and other risk factors like dyslipidemia cause vascular endothelial damage via oxidative stress, and a vicious cycle with the characteristics of atherosclerosis ensues.5
Recent studies paid particular focus on PAD as COPD comorbidities because it has been unclear that prevalence of PAD in COPD patients. Major risk factors of PAD are diabetes mellitus, smoking, hypertension, hyperlipidemia, and kidney dysfunction. Ankle-brachial index (ABI) is the primary noninvasive evaluation to diagnose PAD.
The reported prevalence of PAD in COPD patients ranges widely, from 8.0% to 81.4%. (Table 2). The recent large-scale observational COPD and Systemic Consequences-Comorbidities Network (COSYCONET) study reported by Houben-Wilke et al10 recruited 2,741 patients with COPD, with 2,088 included in final analyses. The prevalence of PAD was higher in patients with COPD than in those with non-COPD among the age- and sex-matched cohort (8.8% vs.1.8%-2.6%, respectively).
PAD is more prevalent in patients with more severe COPD (Global Initiative for Chronic Obstructive Lung Disease [GOLD] stage I-IV: 5.1%, 7.4%, 11.1%, and 9.5%, respectively). Moreover, functional capacity evaluated by the six-minute walking test was significantly lower in COPD patients with PAD than those without PAD (256 m vs. 422 m, p<0.001).
Furthermore, health status evaluated by the COPD-specific St. George’s Respiratory Questionnaire, COPD Assessment Test, and EuroQol-5 Dimensions questionnaire was significantly worse in COPD
patients with PAD than those without PAD. However, the rate of COPD in PAD patients is currently not known, which warrants future investigation.
Pulm Res Respir Med Open J. 2017; SE(2): S63-S66. doi:10.17140/PRRMOJ-SE-2-110
