The impact of aging on COPD, cardiovascular comorbidities and systemic inflammation

Aging is an important risk factor for many chronic diseases, including COPD. COPD patients commonly associate a large number of comorbidities, especially cardiovascular diseases (CVD). Aging process is correlated with a low grade of systemic inflammation. Our study aimed to evaluate the association between aging, systemic inflammation and the presence of CVD in stable COPD patients. Methods and Findings: We included 42 patients with stable COPD: group A (20 subjects <65 years) and group B (22 subjects > 65 years). Medical history, blood samples and inflammatory markers (C reactive protein-CRP, interleukin 6-IL6, tumor necrosis alpha factor-TNFα) and endothelin 1-ET1 were collected. Patients completed CAT questionnaire, performed respiratory functional tests and 6 minutes walking distance test (6MWD). They were also investigated by ECG and echocardiography. Results: Group B had a higher no. of CV comorbidities (2 vs 3, p=0,042), reduced exercise capacity (6MWD 434 vs 343 m, p=0,022), elevated levels of inflammatory biomarkers: IL6 (6,39 vs 7,74 pg/ml, p=0,08), TNFα (6,48 vs 9,02 pg/ml, p=0,03) and ET1 (1,67 vs 2,24 pg/ml, p=0,04) and slightly increased no. of exacerbations/year (1 vs 2, p=0,061), compared with group A. Conclusion: Older patients with stable COPD associate a low degree of systemic inflammation, a higher prevalence of CVD, more frequent exacerbations and more limited exercise tolerance, compared with younger ones. In this group, systemic inflammation expressed by increased levels of IL6, TNFα and ET1, could be one of the missing links between COPD and other comorbidities. This observation could have important therapeutic implications.