Introduction

The correlation between pulmonary function and hypertension remains ambiguous. This study therefore determined the relationship between pulmonary function and hypertension among adult subgroup in Malaysia.

Materials and methods

Data for this study were obtained from an ongoing Prospective Urban Rural Epidemiology- Rural Urban Study (PURE RUS) , which is a prospective cohort study done by MARA University of Technology (UiTM) Medical Faculty research team to track risk factors, changing lifestyles, and chronic diseases in rural and urban population. The inclusion criteria included: Malaysian citizen, age 18-80 years, not on any anti-hypertensive agents, and able to perform lung function test. 1640 participants satisfied the criteria and were recruited in this study.

Results

From the studied population, males comprised 43.5% of them and female comprised 56.5%. A significant inverse relationship was found between pulmonary function and systolic blood pressure in both sexes measured by forced vital capacity (FVC) and Forced Expiratory Volume in 1 second (FEV1). A substantial inverse relationship was also found between pulmonary function and age, and there was a profound positive association between blood pressure and age. No major disparities were significant in pulmonary function between hypertensive and age-matched normotensive participants.

Conclusion

Even though a substantial inverse relationship was evident between systolic blood pressure and pulmonary function, its precise clinical importance needs to be further explored particularly when age can influence both pulmonary function and blood pressure. Clearly, the impact of age has to be removed before FVC can be used as a prognosticator of hypertension.

1. Kearney PM, Whelton M, Reynolds K, Whelton PK, He J. Worldwide prevalence of hypertension: a systematic review. J Hypertens. 2004; 22(1): 11-9.
2. Group ISoHW. International Society of Hypertension (ISH): statement on the management of blood pressure in acute stroke. J Hypertens. 2003; 21(4): 665-72.
3. Chan YY, Teh CH, Lim KK, Lim KH, Yeo PS, Kee CC, et al. Lifestyle, chronic diseases and self-rated health among Malaysian adults: results from the 2011 National Health and Morbidity Survey (NHMS). BMC Public Health. 2015; 15(1): 754.
4. Wolf-Maier K, Cooper RS, Banegas JR, Giampaoli S, Hense H-W, Joffres M, et al. Hypertension prevalence and blood pressure levels in 6 European countries, Canada, and the United States. JAMA. 2003;289 (18): 2363-9.
5. Sparrow D, Weiss ST, Vokonas PS, Cupples LA, Ekerdt DJ, Colton T. Forced vital capacity and the risk of hypertension: the Normative Aging Study. Am J Epidemiol. 1988; 127(4): 734-41.
6. Selby JV, Friedman GD, Quesenberry JR CP. Precursors of essential hypertension: pulmonary function, heart rate, uric acid, serum cholesterol, and other serum chemistries. Am J Epidemiol. 1990; 131(6): 1017-27.
7. Wu Y, Vollmer WM, Buist AS, Tsai R, Cen R, Wu X, et al. Relationship between lung function and blood pressure in Chinese men and women of Beijing and Guangzhou. Int J Epidemiol. 1998; 27(1): 49-56.
8. Schnabel E, Karrasch S, Schulz H, Gläser S, Meisinger C, Heier M, et al. High blood pressure, antihypertensive medication and lung function in a general adult population. Respir Res. 2011; 12(1): 50.
9. Schnabel E, Nowak D, Brasche S, Wichmann H-E, Heinrich J. Association between lung function, hypertension and blood pressure medication. Respir Med. 2011; 105(5): 727-33.
10. Koo H, Kim D, Chung H, Lee CH. Association between metabolic syndrome and rate of lung function decline: a longitudinal analysis. Int J Tuberculosis Lung Dis. 2013; 17(11): 1507-14.
11. Miller MR, Crapo R, Hankinson J, Brusasco V, Burgos F, Casaburi R, et al. General considerations for lung function testing. Eur Respir J. 2005; 26(1): 153-61.
12. Crapo RO, Morris AH, Gardner RM. Reference spirometric values using techniques and equipment that meet ATS recommendations. Am Rev Respir Dis. 1981; 123(6): 659-64.
13. Singh R, Singh HJ, Sirisinghe RG. Forced vital capacity in Malaysian females. Jpn J Physiol. 1992; 42(3): 407-14.
14. Singh R, Singh HJ, Sirisinghe RG. Spirometric studies in Malaysians between 13 and 69 years of age. Med J Malaysia. 1993; 48(2): 175-84.
15. Singh R, Singh HJ, Sirisinghe RG. Spirometric volumes in Malaysian males. Southeast Asian J Tropical Med Public Health. 1994; 25: 341-8.
16. Singh R, Singh H, Sirisinghe R. Cardiopulmonary capacities of Malaysian females. Singapore Med J. 1995; 36: 169-72.
17. Enright PL, Kronmal RA, Smith V-E, Gardin JM, Schenker MB, Manolio TA. Reduced vital capacity in elderly persons with hypertension, coronary heart disease, or left ventricular hypertrophy: the Cardiovascular Health Study. Chest. 1995; 107(1): 28-35.
18. Margretardottir OB, Thorleifsson SJ, Gudmundsson G, Olafsson I, Benediktsdottir B, Janson C, et al. Hypertension, systemic inflammation and body weight in relation to lung function impairment—an epidemiological study. J Chronic Obstruct Pulmon Dis. 2009; 6(4): 250-5.
19. Rohrscheib MR, Myers OB, Servilla KS, Adams CD, Miskulin D, Bedrick EJ, et al. Age-related blood pressure patterns and blood pressure variability among hemodialysis patients. Clin J Am Soc Nephrol. 2008; 3(5): 1407-14.
20. Janssens J-P. Aging of the respiratory system: impact on pulmonary function tests and adaptation to exertion. Clin Chest Med. 2005; 26(3): 469-84.
21. Irving S. An epidemiologic-study of cardiovascular and cardiopulmonary disease risk-factors in 4 populations in the peoples-republic-of-china-base-line report from the prc-usa collaborative study. Lippincott Williams & Wilkins, Philadelphia; 1992. p. 1083-96.
22. Benfante R, Reed D, Brody J. Biological and social predictors of health in an aging cohort. J Chronic Dis. 1985; 38(5): 385-95.
23. Duprez DA, Hearst MO, Lutsey PL, Herrington DM, Ouyang P, Barr RG, et al. Associations among lung function, arterial elasticity, and circulating endothelial and inflammation markers: the multiethnic study of atherosclerosis. Hypertension. 2013; 61(2): 542-8.
24. Dressler WW, Bindon JR. Social status, social context, and arterial blood pressure. Am J Physical Anthropol. 1997; 102(1): 55-66.
25. Mungreiphy NK, Kapoor S, Sinha R. Association between BMI, blood pressure, and age: study among Tangkhul Naga tribal males of Northeast India. Journal of Anthropology. 2011; 2011: 748147.
26. Tee SR, Teoh XY, Aiman W, Aiful A, Har CSY, Tan ZF, et al. The prevalence of hypertension and its associated risk factors in two rural communities in Penang, Malaysia. IeJSME. 2010; 2: 27-40.
27. Engström G, Wollmer P, Valind S, Hedblad B, Janzon L. Blood pressure increase between 55 and 68 years of age is inversely related to lung function: longitudinal results from the cohort study ‘Men born in 1914’. J Hypertens. 2001; 19(7): 1203-8.