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. 2011 Apr 21:11:20.
doi: 10.1186/1471-2466-11-20.

Does pulmonary rehabilitation address cardiovascular risk factors in patients with COPD?

Nichola S Gale  1 , James M Duckers, Stephanie Enright, John R Cockcroft, Dennis J Shale, Charlotte E Bolton
Affiliations

Does pulmonary rehabilitation address cardiovascular risk factors in patients with COPD?

Nichola S Gale et al. BMC Pulm Med. .

Abstract

Background: Patients with COPD have an increased risk of cardiovascular disease. Whilst pulmonary rehabilitation has proven benefit for exercise tolerance and quality of life, any effect on cardiovascular risk has not been fully investigated. We hypothesised that pulmonary rehabilitation, through the exercise and nutritional intervention, would address these factors.

Methods: Thirty-two stable patients with COPD commenced rehabilitation, and were compared with 20 age and gender matched controls at baseline assessment. In all subjects, aortic pulse wave velocity (PWV) an independent non-invasive predictor of cardiovascular risk, blood pressure (BP), interleukin-6 (IL-6) and fasting glucose and lipids were determined. These measures, and the incremental shuttle walk test (ISWT) were repeated in the patients who completed pulmonary rehabilitation.

Results: On commencement of rehabilitation aortic PWV was increased in patients compared with controls (p<0.05), despite mean BP, age and gender being similar. The IL-6 was also increased (p<0.05). Twenty-two patients completed study assessments. In these subjects, rehabilitation reduced mean (SD) aortic PWV (9.8 (3.0) to 9.3 (2.7) m/s (p<0.05)), and systolic and diastolic BP by 10 mmHg and 5 mmHg respectively (p<0.01). Total cholesterol and ISWT also improved (p<0.05). On linear regression analysis, the reduction in aortic PWV was attributed to reducing the BP.

Conclusion: Cardiovascular risk factors including blood pressure and thereby aortic stiffness were improved following a course of standard multidisciplinary pulmonary rehabilitation in patients with COPD.

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Figures

Figure 1
Figure 1
Change in Aortic Pulse Wave Velocity and Mean Arterial Pressure with Pulmonary Rehabilitation in patients with COPD. Solid lines represent the change in aortic pulse wave velocity (PWV), triangles denote the mean change in aortic PWV. Dotted lines show the change in mean arterial pressure (MAP), diamonds indicate mean change in MAP.
See this image and copyright information in PMC

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