Cardiorespiratory fitness, arterial stiffness and rheumatic disease

ObjectivesArterial stiffness is increased in patients with inflammatory rheumatic disease, independent of traditional cardiovascular (CV) risk factors. In contrast, aerobic exercise training has a beneficial effect on arterial stiffness. Our aim was to investigate the cross-sectional relationship between arterial stiffness and cardiorespiratory fitness (CRF) in patients with a rheumatic disease but without traditional cardiovascular risk factors.MethodsPulse wave velocity (PWV), augmentation index corrected to a set heart rate of 75bpm (Aix@75) and central pulse pressure (cPP) recorded by applantation tonometry were analysed as parameters for arterial stiffness. CRF was assessed as peak oxygen consumption (VO2peak) measured in a maximal cycle ergometer test. Primary regression analyses adjusted for age and sex were executed to evaluate the influence of one metabolic equivalent (MET=3.5ml/kg/min) increment in VO2peak on arterial stiffness parameters.ResultsTwenty-eight patients with rheumatoid arthritis, psoriatic arthritis or ankylosing spondylitis were recruited. Aix@75 decreased significantly by -1.570% (95% confidence interval (CI) -2.888; -0.251) for every MET increase in VO2peak when adjusted for age and sex. PWV and cPP were not significantly influenced by increased VO2peak but tended to a decrease of -0.092 m/s (95% CI -0.286; 0.103) and -0.359mmHG (95% CI -1.665; 0.947) respectively.ConclusionThere is an inverse relationship between arterial stiffness and CRF in patients with an inflammatory rheumatic disease in the absence of traditional cardiovascular risk factors. An increased CRF has a stronger beneficial influence on Aix@75 than on PWV. Since Aix@75 represents global arterial stiffness and PWV primarily central arterial stiffness, aerobic exercise might have a particularly beneficial effect on peripheral arteries.