A14935 Airflow limitation predicts the development of hypertension in normotensive smokers

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Objectives: Although airflow limitation is reported to be associated with cardiovascular disease, the association with hypertension has not been intensively discussed in normotensive individuals. We studied whether airflow limitation predicts new onset of hypertension in the general population. Methods: Normotensive 5279 participants (male = 3273, 53.2 year-old) in our physical checkup program were enrolled and followed up (median 2177 day) with the endpoint being the development of hypertension. Airflow limitation was evaluated using a ratio of forced expiratory volume in 1 second to a forced vital capacity (FEV1%). Results: At baseline, their FEV1% was 81.5 ± 6.8 %. During the follow-up, hypertension developed in 1531 subjects (57.6 per 1000 person-year). FEV1% at baseline was lower in subjects with than without future hypertension (80.7 ± 6.9 vs. 81.9 ± 6.7 %, p < 0.001) in retrospective analysis. Although non-adjusted hazard ratio (HR) (95% confidence interval [CI]) of FEV1% for the incident hypertension was 0.975 (0.968–0.982), there was no relationship between FEV1% and new onset hypertension in multivariate Cox-hazard analysis. However, when subjects were divided into 3 groups according to smoking status; never smokers (n = 2921), ex-smokers (n = 987) and active smokers (n = 1371), FEV1% was a significant predictor of future hypertension in active smokers by multivariate analysis (HR = 0.983, 95%CI = 0.969–0.997). Conclusion: Airflow limitation is associated with the development of hypertension in the normotensive general population with habitual smoking. Smoking secession is strongly recommended to prevent pulmonary dysfunction and new onset of hypertension.