Relationship between Lung Function and Hypertension among Rural Canadians using Fractional Polynomials

Abstract

Studies have shown that persons with lower pulmonary function have a higher risk for developing cardiovascular diseases including hypertension. The objectives of this paper are to examine: (i) the relationship between lung function and hypertension; and (ii) the correct functional forms of the continuous predictors of hypertension using fractional polynomials. This analysis was based on data from a cross-sectional community study of 1,834 adult subjects aged 18-79 years conducted in 2003 in Humboldt, Saskatchewan, Canada. Clinical measurements were made during a clinic visit, and other information was collected from a questionnaire. Logistic regression analysis was conducted to determine associations between hypertension and lung function measurements. Multivariate fractional polynomial logistic regression model was used to preserve the continuous nature of the predictor variables. There was an expected significant difference between men and women in values for FVC and FEV 1. We observed that the ordinary logistic regression model and fractional polynomial model gave the same functional form when stratified by gender. The data suggest an increasing risk of hypertension with decreasing FVC and FEV 1 values. After adjusting for potential risk factors including age, body mass index, parental history of hypertension and smoking, there was increased risk of hypertension among women with low FVC [OR adj : 0.73 (95% CI: 0.56, 0.95)]. We did not see this association for men [OR adj : 1.10 (95% CI: 0.90, 1.33)]. We observed that the risk of hypertension increases with decreasing FVC for women after adjusting for potential risk factors.

Cardiovascular disease risk in people with spinal cord injury: is there a possible association between reduced lung function and increased risk of diabetes and hypertension?

“…14,36 Cohort studies have shown that the reduced lung function parameters are strong, inverse predictors for the future development of hypertension in the able-bodied population. 14,16,17,19,22,44,45 In addition, it has been reported that, although the changes in lung function were predictive of incident hypertension, changes in blood pressure were not predictive of loss of lung function. 19 Furthermore, it has been found that the incidence of CVD and death associated with hypertension is increased in the presence of reduced lung function.…”

“…8,9,12,13 In the general population, there is strong evidence that people with lower lung function measures (in the absence of overt respiratory symptoms or disease) have a higher risk for developing DM and hypertension. 4,[14][15][16][17][18][19][20][21][22] Lung function predicts the development of insulin resistance or DM, 14,15,20,21 and it is also a useful predictor of subsequent development of hypertension in able-bodied people. [16][17][18]22,23 Although CVD is a major cause for mortality in the SCI population, it is not yet known whether the same association between reduced lung function and future development of DM and hypertension exists in people with SCI.…”

Association between lung function and hypertension and home hypertension in a Japanese population: the Tohoku Medical Megabank Community-Based Cohort Study

“…In this study, we only used data from type 2 survey (n ¼ 13 855) participants who underwent several physiological measurements, including lung function tests. We excluded those who withdrew from the study by 13 July 2021, failed to return the self-reported questionnaire, did not undergo physiological measurements, or had missing data regarding lung function, SBP, DBP, plasma glucose, glycated hemoglobin A1c (HbA1c), total cholesterol (TC), triglyceride, high-density lipoprotein cholesterol (HDL-C), urinary creatinine, estimated urinary 24-h sodium excretion, estimated urinary 24 h potassium excretion and white blood cell (WBC) count (n ¼ 1332). Finally, data from 12 523 participants (3728 men and 8795 women) were analyzed.…”

“…Hypertension is a well known leading risk factor for cardiovascular disease [5]. Therefore, several studies have examined the association between lung function and hypertension [6][7][8][9][10][11][12][13][14], and these studies have shown that lung function is inversely associated with blood pressure (BP) and hypertension [6][7][8][9][10][11][12][13]. However, only a few studies have reported an association between lung function and hypertension among never-smokers [7,8], although smoking is closely associated with reduced lung function and is positively associated with BP [15][16][17][18].…”