Background Although the arteriosclerosis locally assessed by carotid intima-media thickness develops with COPD, it has not been elucidated whether systemic arteriosclerosis assessed by cardio-ankle vascular index (CAVI) develops in individuals with COPD, particularly in elderly subjects. Methods This study is a multicenter cross-sectional study. Outpatients and their families who had ever smoked and outpatients and their families who had never smoked were included in three hospitals. Healthy subjects were additionally recruited in an event to check their health. The subjects performed spirometry and CAVI measurements. Based on spirometry and smoking history, the subjects were divided into three groups: never-smokers with normal spirometry (NS), past-smokers with NS, and past-smokers with airflow limitation (AL). Logistic regression analysis was performed with CAVI as objective variables and with the factors related to arteriosclerosis as the explanatory variables by binarizing each variable. Single regression analysis and comparisons between groups were also performed. Results As a result, 83 never-smokers with NS, 49 past-smokers with NS, and 64 past-smokers with AL were included with a mean (SD) age of 73.3 (10.8). Logistic regression analysis showed that higher age (≥ 75) and pack-years (≥ 20) were significantly associated with higher CAVI (a cutoff of ≥ 9) (odds ratio = 8.9 and 2.9, respectively; p < 0.01). CAVI was significantly correlated with age, pack-year, and %FEV1 (age, r = 0.54, p < 0.01; pack-years, r = 0.35, p < 0.01%; FEV1, r = − 0.28, p < 0.01). There was no significant difference in CAVI between past-smokers with NS and past-smokers with AL after adjusting for age, pack-years, and BMI. Conclusion This study newly suggests that systemic arteriosclerosis may be strongly associated with age and smoking history rather than airflow limitation in elderly subjects. Ethics and dissemination All subjects were given an adequate explanation of the study and provided written informed consent to participation. This study was conducted after obtaining approval from the Shinshu University of Medical Ethics Committee (approval number: 3767). Trial registration Shohei Kawachi, UMIN000048909, 1 October 2022 (retrospectively registered).

Arterial stiffness in former elderly smokers is associated with aging and smoking but not airflow limitation: a cross-sectional study

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2025年7月28日

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Shohei Kawachi,
Keisaku Fujimoto

摘要

Background

Although the arteriosclerosis locally assessed by carotid intima-media thickness develops with COPD, it has not been elucidated whether systemic arteriosclerosis assessed by cardio-ankle vascular index (CAVI) develops in individuals with COPD, particularly in elderly subjects.

Methods

This study is a multicenter cross-sectional study. Outpatients and their families who had ever smoked and outpatients and their families who had never smoked were included in three hospitals. Healthy subjects were additionally recruited in an event to check their health. The subjects performed spirometry and CAVI measurements. Based on spirometry and smoking history, the subjects were divided into three groups: never-smokers with normal spirometry (NS), past-smokers with NS, and past-smokers with airflow limitation (AL). Logistic regression analysis was performed with CAVI as objective variables and with the factors related to arteriosclerosis as the explanatory variables by binarizing each variable. Single regression analysis and comparisons between groups were also performed.

Results

As a result, 83 never-smokers with NS, 49 past-smokers with NS, and 64 past-smokers with AL were included with a mean (SD) age of 73.3 (10.8). Logistic regression analysis showed that higher age (≥ 75) and pack-years (≥ 20) were significantly associated with higher CAVI (a cutoff of ≥ 9) (odds ratio = 8.9 and 2.9, respectively; p < 0.01). CAVI was significantly correlated with age, pack-year, and %FEV₁ (age, r = 0.54, p < 0.01; pack-years, r = 0.35, p < 0.01%; FEV₁, r = − 0.28, p < 0.01). There was no significant difference in CAVI between past-smokers with NS and past-smokers with AL after adjusting for age, pack-years, and BMI.

Conclusion

This study newly suggests that systemic arteriosclerosis may be strongly associated with age and smoking history rather than airflow limitation in elderly subjects.

Ethics and dissemination

All subjects were given an adequate explanation of the study and provided written informed consent to participation. This study was conducted after obtaining approval from the Shinshu University of Medical Ethics Committee (approval number: 3767).

Trial registration

Shohei Kawachi, UMIN000048909, 1 October 2022 (retrospectively registered).