Hypertension, Systemic Inflammation and Body Weight in Relation to Lung Function Impairment—An Epidemiological Study

Abstract

Recent reports on the simultaneous occurrence of systemic inflammation and airflow obstruction are usually based on a highly selective patient population, but their importance warrants further evaluation in the general population. The objectives were to study the interrelationship between airflow obstruction, smoking, hypertension, obesity and CRP as a marker of systemic inflammation in a randomly selected sample of the general Icelandic population (n = 939). This study comprised 758 randomly selected men and women 40 years and older living in Reykjavik, Iceland, and who were participating in the Burden of Obstructive Lung Disease (BOLD) study (81% response rate). In addition to the BOLD protocol, which included post-bronchodilator spirometry, they answered questions about general health and medication. Serum samples were taken for measurement of C-reactive protein (CRP). In the sample-245 individuals (33%) reported having hypertension. Subjects with hypertension were older, had a higher BMI and higher CRP levels. Subjects with hypertension had lower values of FEV(1) than predicted (89.9 +/- 18.5 vs. 94.5 +/- 14.4%) (p < 0.001) and FVC (92.2 +/- 15.1 vs. 95.3 +/- 12.3%) (p = 0.002). These differences remained significant after adjusting for age, BMI, CRP and smoking. Hypertension and CRP levels above the median were both independently and additively associated with lower FEV(1) and FVC. In addition a lower FVC% was also associated with a higher BMI (> 30 mg/m2). Use of betablocking antihypertensives was not related to lung function. Hypertension, BMI and systemic inflammation affect lung function independently of each other. All three variables have a negative effect on FVC, while hypertension and high CRP were independently associated with impaired FEV(1).

Long-Term Effects of Ambient PM 2.5 on Hypertension and Blood Pressure and Attributable Risk Among Older Chinese Adults

“…It was possible that systematic inflammation has played a role as PM 2.5 -induced inflammation has been reported to be higher among participants with higher BMI. 35 This finding has also been supported by animal experimental studies, 36 which showed that obese mice presented higher airway inflammation than normal-weighted mice.…”

Nocturnal sweating—a common symptom of obstructive sleep apnoea: the Icelandic sleep apnoea cohort

“…15 19-21 At the end of November 2004, of the 73 391 subjects ≥ 40 years of age living in the area, 939 subjects were randomly selected to participate (for details, see ref. 19). Altogether, 762 of the 939 eligible subjects (81.2%) responded.…”

Improved Air Quality and Attenuated Lung Function Decline: Modification by Obesity in the SAPALDIA Cohort

“…Effects of obesity on airway caliber and obstruction to air flow that were not merely explained by a mechanical effect on lung volume have been reported in a limited number of studies (e.g., Salome et al 2010). It is hypothesized that proinflammatory adipokines produced by adipose tissue may contribute to airway remodeling in obese persons (Margretardottir et al 2009; McClean et al 2008; Tkacova 2010). Circulating inflammatory markers and adipokines (e.g., soluble tumor necrosis factor receptor 1, adiponectin, leptin) were inconsistently associated with respiratory function in subjects with excess body weight (Lecube et al 2011; Thyagarajan et al 2010).…”