Document Type : Research Paper


1 Assistant Professor of Internal Medicine, Emam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran

2 Assistant Professor of Cardiovascular, Emam Reza Hospital, MashhadUniversity of Medical Sciences, Mashhad, Iran

3 Professor of Pathology, EmamReza Hospital, MashhadUniversity of Medical Sciences, Mashhad, Iran

4 Resident of Internal Medicine, Emam Reza Hospital, MashhadUniversity of Medical Sciences, Mashhad, Iran


COPD is a common pulmonary disease. One of the inflammatory factors in COPD is CRP which has a pathogenic role in pulmonary hypertension; therefore, our aim was to investigate the relationship between the level of serum CRP and pulmonary hypertension in COPD Patients.
Materials and Methods
This prospective study was done from 2007 to 2008 in patients of pulmonary ward. Initially, COPD was confirmed in patients; and active infections, collagen vascular disease, heart disease, cancers and other diseases were ruled out. Mean pulmonary pressure was measured by echocardiography. Quantitative serum CRP was measured and compared with pulmonary hypertension.
From fifty five patients, forty were male and fifteen were female. Mean age was 63.67 year with SD of 9.94 years. According to the Gold Criteria, twenty-eight males and seven females had severe and very severe disease. Thirty-three males and thirteen females had mild pulmonary hypertension. Mean level of FEV1 percentage was 38.2 with SD of 17.39. Between the level of FEV1 percentage and hs CRP was seen an inverse linear correlation. Between quantitative serum CRP and mean pulmonary pressure a frank direct linear correlation was seen.
CRP induces pulmonary hypertension in COPD and measurement of serum hs CRP for estimating severity of pulmonary hypertension is useful, cost efficient, easy and available.


1- Rand Sutherland E, Cherniack M. Management of chronic obstructive pulmonary disease. N Engl J Med 2004; 26:
2689 – 2697.
2-Halvani A, Nadooshan H. Serum C – reactive protein level in COPD patients and noral population. Tanaffos 2007;
3-Joppa P, Petrasova D, Stancak B, Tkacova R. Systemic inflammation in patients with COPD and pulmonary
Hypertension. Chest 2006; 130:326-333.
4- Rich S, Maclaughlin V. V. Pulmonary hypertension. In: Zipes D. P, Libby P, Bonow R. O , et al. Heart disease. 7th
ed . Elsevier Saunders; 2005.p.1807-1816.
5- Rich S. Pulmonary hypertension. In: Fauci A S, Kasper D, Longo D. L , et al. Principles of Internal Medicine. 17 th
ed. McGrawHill: 2008 .p.1576-1581.
6-Falk A, Kadiev S, Criner Gو Scharf SM, Minai OA, Diaz P. Cardiac disease in chronic obstructive pulmonary
disease. Proc Am Thorac Soc 2008; 5:543-548.
7-Bossone E, Dibobodini B, Mazza A, Allegra L. Pulmonary arterial hypertension. The key role of echocardiography.
Chest 2005; 127: 1836 - 1843
8-Garrod R, Barley E, Barley E, Fredericks S, Hagan G.The relationship between inflammatory markers and disability
in chronic obstructive pulmonary disease (COPD). Prim care respire J 2007; 16: 236 – 40.
9-Lee TM, Lin MS, Chang NC. Usefulness of C – reactive protein and interleukin – 6 as predictors of outcomes in
patient with chronic obstructive pulmonary disease receiving pravastalin. Am J Cardiol 2008; 101:530 – 5. Epub 2007
Dec 26.
10- De torres T, Cordoba – Lanus – E, López-Aguilar C, Muros de Fuentes M, Montejo de Garcini A Aguirre-Jaime A,
et al. C–reactive protein levels and clinically important predictive out comes in stable COPD patients. Eur Respir J
2006; 27:902 – 907.
11- Sin Doud, Paulman F. Is systemic Inflammation responsible for pulmonary hypertension in COPD? Chest 2006;
130: 310-312.
12- Barbera JA, Peinado I, Santos S. Pulmonary hypertension in chronic pulmonary disease. Eur Respir J 2003;
13- Weitzenblum D, Chaouat A. Severe pulmonary hypertension in COPD. Chest 2005; 127: 1480-1482.