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

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.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.Cardiovascular risk factors including blood pressure and thereby aortic stiffness were improved following a course of standard multidisciplinary pulmonary rehabilitation in patients with COPD.Chronic obstructive pulmonary disease (COPD) is an increasing cause of global morbidity and mortality [1] of which cardiovascular (CV) disease accounts for approximately 30% of the excess mortality in patients [2]. Such patients have multiple risk factors for CV disease including exposure to significant cigarette smoke, physical inactivity and metabolic disorders [3]. In addition, arterial stiffness measured by aortic pulse wave velocity (PWV) is an independent predictor of CV risk [4,5], which is increased in patients with COPD [6].In the general population, addressing physical activity and nutritional optimisation, both components of multidisciplinary pulmonary rehabilitation, are associated with reducing the CV risks such as blood pressure (BP) and