The role of smoking in development of endothelial dysfunction in patients with COPD in combination with AH

Abstract

Endothelial dysfunction (ED) is a pathological finding of COPD and arterial hypertension (AH) at different stages.Incidence of AH in patients with COPD is higher than in the population.The important risk factor of COPD and AH is smoking which may initiate vascular impairment by stimulate adhesion molecule expression and leukocyte adhesion to endothelium.

Aims: The purpose of study was to find out the role of ED in the pathogenesis of COPD in combination with AH using sVCAM-1, and to study the reversibility of changes in the endothelium after smoking cessation.

Methods: Plasma levels of sVCAM-1 were quantified by ELISA in age-matched 45 patients with COPD and AH (mean age 61±6,5) that were either current smoking COPD patients with AH (n=12) and COPD ex-smokers with AH (n=12),to be compared with smokers (n=10) and nonsmokers with AH (n=11).

Results: The comparison of smoking (19.5±4.8) and ex-smoking (15.5±3.6) COPD patients with AH revealed that level of sVCAM-1 was higher in smokers (p<0.05). There is no difference in smokers with AH (14.7±5.4) comparing with non-smokers (16.5±4.7). We have found difference between smokers with COPD and AH and smokers with AH (p<0.05), and a correlation between sVCAM-1 plasma level and the age (r=0.46,p<0.05).

Conclusions: Our results show that COPD smokers with AH have more evident expression of adhesion molecule to endothelium to be compared with ex-smokers. The combination of COPD and AH has more evident contribution in development of ED.The less evident of ED in ex-smoking patients shows reversibility of these changes.Correlation between sVCAM-1 and age shows that ED in elderly patients plays important pathogenetic role in comparing with middle age patients.