Abstract
Background:Vascular and lung function develop and decline over the life course; both predict cardiovascular events and mortality but little is known of how they develop over time. We analysed their relationship in a multiethnic cohort study to test whether lung function from early adolescence to young adulthood affected vascular indices.Methods:‘DASH’ (http://dash.sphsu.mrc.ac.uk) included 6643 children aged 11–13 years in 2003; a representative 10% sample (n = 665) participated in a pilot follow-up in 2013. Psychosocial, anthropometric, blood pressure (BP), and lung function measures were collected in both surveys; aortic pulse wave velocity (PWV) and augmentation index (AIx) were measured at aged 21–23 years. Relationships between forced expiratory volume Z-scores in 1 s (zFEV1), after global initiative-ethnic adjustments and BP, PWV, and AIx were tested in linear regression and general estimating statistical models.Results:In total, 488 people with complete data were included. At 11–13 years, SBP was positively associated with zFEV1 (coefficient = 1.90, 95% confidence interval 1.11–2.68, P < 0.001); but not at 21–23 years. The 10-year increase in zFEV1 was associated with rise in SBP (1.38, 0.25–1.51, P < 0.05) in mixed effect models adjusted for age, sex, ethnicity, waist to height ratio, employment, reported racism, smoking, and alcohol use but DBP change was unrelated. In fully adjusted models, neither PWV nor central AIx were associated with zFEV1 at 11–13 years or 21–23 years (P > 0.05).Conclusion:Forced expiratory volume change is positively and independently associated with SBP change from adolescence to young adulthood, suggesting earlier lung function plays important roles in SBP development. Vascular indices were unrelated to lung function or its change.
Highlights
I n adulthood, impaired lung function is inversely related to the incidence of stroke [1], myocardial infarction, and cardiovascular mortality [2], independently of traditional cardiovascular risk factors in middle-age populations
Lung development starts in utero and continues through adolescence and early adulthood [3,4], which raises the question whether suboptimal lung growth and development could affect later vascular function and blood pressure (BP)
In middle aged (45–59 years) and elderly (>60 years) population, lung function parameters measured at age 40 were stronger predictors of arterial stiffness [aortic pulse wave velocity (PWV) and pressure or flow wave reflection measured as augmentation index (AIx)] than lung function at age 60 [8,9,10]
Summary
I n adulthood, impaired lung function is inversely related to the incidence of stroke [1], myocardial infarction, and cardiovascular mortality [2], independently of (after adjustment for) traditional cardiovascular risk factors in middle-age populations. Lung function and vascular function may track each other through convergent inflammatory or metabolic pathways throughout life, or genetic susceptibility Such low-grade systemic inflammation is indicated by Journal of Hypertension 2017, 35:2185–2191 aDivision of Diabetes and Nutritional Sciences, Cardiovascular Medicine Group, King’s College London, London, UK, bCentre of Clinical Pharmacy, The Third Xiangya Hospital, Central South University, Changsha, China, cRespiratory, Critical Care and Anaesthesia section, University College London Great Ormond Street Institute of Child Health, London, UK, dMRC/CSO Social and Public Health Sciences Unit, Institute of Health and Wellbeing, University of Glasgow, Glasgow, Scotland and eDepartment Epidemiology and Health, ESRC International Centre for Lifecourse Studies in Society and Health, University College London, London, UK. Vascular and lung function develop and decline over the life course; both predict cardiovascular events and mortality but little is known of how they develop over time We analysed their relationship in a multiethnic cohort study to test whether lung function from early adolescence to young adulthood affected vascular indices
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