Researchers have found that a higher risk for developing vascular disease among patients diagnosed with bronchiectasis is linked to the severity of the disease.
The study, “Bronchiectasis severity is an independent risk factor for vascular disease in a Bronchiectasis Cohort,” was recently published in the journal Chest.
Vascular diseases such as increased coronary artery calcification (the coronary arteries are important vessels that supply blood to the heart muscle) have been associated with higher morbidity and mortality among patients with chronic obstructive pulmonary disease (COPD). The same pattern has also been detected in cases of pneumonia. But there is limited data on the vascular disease risk in patients with bronchiectasis.
Now, a team of researchers investigated the prevalence of vascular disease in patients with bronchiectasis, and identified independent risk factors for vascular disease that developed following the diagnosis of bronchiectasis.
The team conducted a retrospective study with 400 patients attending a specialist bronchiectasis clinic in the NHS (National Health System) Lothian, Edinburgh, in the United Kingdom. The team analyzed data on patients’ visits between May 2013 and September 2014.
Researchers assessed the prevalence of vascular disease, defined here as having a history of ischemic heart disease (characterized by reduced blood supply to the heart), cerebrovascular disease, peripheral vascular disease, or atrial fibrillation (an abnormal heart rhythm characterized by rapid and irregular beating).
The team identified pre-existing vascular disease before the diagnosis of bronchiectasis in 44 patients (11%). In 45 patients (11%), researchers detected vascular disease after the diagnosis of bronchiectasis after a mean period of 9.4 years.
Researchers found that several parameters, including male gender, hypertension, long-term statin treatment, and moderate or worse bronchiectasis severity, were independently associated with an increase of all-cause vascular disease (ischemic heart disease, cerebrovascular disease, peripheral vascular disease, or atrial fibrillation) that developed after an initial diagnosis of bronchiectasis.
“The potential mechanisms bronchiectasis severity is linked to vascular disease are due to chronic infection of the airways with increased vascular adhesion molecules, systemic inflammation and arterial stiffness,” the team wrote in its report. “Both mechanisms of increased systemic inflammation and arterial stiffness may increase the risk of subsequent vascular disease, as has been shown in patients with COPD and in patients admitted with community acquired pneumonia.”
The results suggest that the severity of bronchiectasis is independently associated with the development of vascular disease after the diagnosis of bronchiectasis.