Terzikhan1, Lies Lahousse1, Katia Verhamme2, Oscar Franco3, Guy
Brusselle1 and Bruno Stricker3
Respiratory Medicine (UGent, Ghent) & Department of
Epidemiology (Erasmus MC, Rotterdam) , Ghent, Belgium, 2Department of
Medical Informatics (ErasmusMC, Rotterdam), Rotterdam, Netherlands,
3Department of Epidemiology (Erasmusmc, Rotterdam), Rotterdam,
COPD patients commonly
present with multi-morbidity, including vascular disease.
Atherosclerosis is known as the main driver of vascular disease. One of
its clinical manifestations is peripheral arterial disease (PAD), which
mainly affects the lower limb arteries. Little is known about the
association between COPD and PAD in the general population. Our aim was
to study the association between COPD and PAD in a population-based
In 3,459 participants of the Rotterdam study (mean age ±
standard deviation 65.4 ± 6.7, 57.4% females), PAD (an Ankle
Brachial Index (ABI) ≤ 0.9) and COPD (based on obstructive
spirometry or clinical presentation) was assessed. The association
between COPD and PAD was tested by means of a cox regression analysis.
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In this study, 13 (13.3%) of individuals with COPD had PAD compared to
323 (9.6%) of individuals without COPD. The incidence of PAD in
individuals with COPD was 32.0/1000 person years (PY), compared to
18.4/1000 PY in individuals without COPD. A statistically significant
association was found between COPD and PAD, with an Hazard Ratio of
1.78 (95% Confidence Interval 1.13-2.), adjusted for age, sex, smoking
history, body mass index, hypertension, statin use, serum HDL to
cholesterol ratio and ethnicity.
Individuals with COPD have higher risk of developing PAD. This
emphasizes the importance of determining ABI for the diagnosis of PAD
in the management of patients with COPD.