School of Public Health, Southeast University, Nanjing, Jiangsu Province, China.
Department of Cardiology, Nanjing Jiangning Hospital, The Affiliated Jiangning Hospital of Nanjing Medical University, Nanjing, Jiangsu Province, China.
J Clin Hypertens (Greenwich). 2021 Oct;23(10):1930-1938. doi: 10.1111/jch.14364. Epub 2021 Sep 16.
Lung function impairment and hypertension, especially hypertension, are risk factors of major adverse cardiovascular events (MACEs). However, the relationships among lung function impairment, hypertension, and MACEs have not been well-reported. We aimed to investigate the association between lung function and hypertension and MACEs. We studied 6769 people who were a representative sample of the general population in Jiangsu Province using the multi-stage stratified cluster sampling method. The average age was 51.54 years. Cox proportional hazards models were used to analyze the relationships between the blood pressure status and various types of lung function impairment related to MACEs. Over a follow-up of 10 years, 236 MACEs occurred. After adjusting for age, sex, BMI, smoking, drinking, education, physical activity, diabetes mellitus, dyslipidemia, creatine and use of antihypertensive drugs, hypertension [hazard ratio (HR) = 2.154, 95% confidence intervals (CI): 1.565-2.966], and restrictive lung function impairment (RLFI) (HR = 1.398, 95% CI: 1.021-1.879) were independently associated with MACEs. Individuals with hypertension and RFLI had the highest risk for MACEs (HR = 2.930, 95% CI: 1.734-4.953) and stroke (HR = 3.296, 95% CI: 1.862-5.832). Moreover, when combined with hypertension, obstructive lung function impairment (OLFI) (HR = 2.376, 95% CI: 1.391-4.056) and mixed lung function impairment (MLFI) (HR = 2.423, 95% CI: 1.203-4.882) were associated with MACEs. There is a synergistic effect of lung function impairment (especially RLFI) and hypertension on MACEs. Therefore, more attention should be paid to the incidence of MACEs in individuals with impaired lung function, especially those who have hypertension.
肺功能损害和高血压,尤其是高血压,是主要不良心血管事件(MACEs)的危险因素。然而,肺功能损害、高血压和 MACEs 之间的关系尚未得到很好的报道。我们旨在研究肺功能与高血压和 MACEs 之间的关系。我们使用多阶段分层聚类抽样方法,对江苏省代表性人群中的 6769 人进行了研究。平均年龄为 51.54 岁。使用 Cox 比例风险模型分析了血压状况与与 MACEs 相关的各种类型的肺功能损害之间的关系。在 10 年的随访中,发生了 236 例 MACEs。在校正年龄、性别、BMI、吸烟、饮酒、教育、体力活动、糖尿病、血脂异常、肌酐和使用降压药物后,高血压[风险比(HR)=2.154,95%置信区间(CI):1.565-2.966]和限制性肺功能损害(RLFI)(HR=1.398,95%CI:1.021-1.879)与 MACEs 独立相关。高血压和 RFLI 患者发生 MACEs 的风险最高(HR=2.930,95%CI:1.734-4.953)和中风(HR=3.296,95%CI:1.862-5.832)。此外,当与高血压合并时,阻塞性肺功能损害(OLFI)(HR=2.376,95%CI:1.391-4.056)和混合性肺功能损害(MLFI)(HR=2.423,95%CI:1.203-4.882)与 MACEs 相关。肺功能损害(尤其是 RLFI)和高血压对 MACEs 有协同作用。因此,应更加关注肺功能受损患者,尤其是患有高血压的患者发生 MACEs 的风险。