Longitudinal study of the influence of lung function on vascular health from adolescence to early adulthood in a British multiethnic cohort

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.

Lung function, obesity and physical fitness in young children: The EXAMIN YOUTH study

“…A previous cross-sectional study found a positive association of systolic BP with FEV1 in 5-year-old children [12]. Similar results were found in the Determinants of Adolescent Social Well-Being and Health (DASH) study in children aged 11-13 years [11]. Longitudinal data showed that changes in FEV1 from 11 to 23 years were associated with changes in systolic BP [11].…”

“…Epidemiological surveys of the past 20 years demonstrate an association between an increased prevalence of obesity and elevated blood pressure (BP) in children and adolescents [9,10]. Whether BP may be associated with lung function independent of BMI has been a matter of debate and potential physiological mechanisms remain unclear [11,12].…”

Associations between respiratory and vascular function in early childhood

“…Alterations to the elastic properties of the vascular tree could result in a reduction in lung elastic recoil. 27,28 For example, a cross-sectional population-based study in the UK found an association between carotid augmentation index and reduced lung function (FEV 1 ) in 11-year-old children who were born preterm. 10 The authors hypothesized that alterations to elastin and collagen production during early development could explain the association between reduced lung function and stiffer blood vessels.…”

“…One possible explanation for this association is the contribution that vascular stiffness makes to the highly perfused peripheral lung. Alterations to the elastic properties of the vascular tree could result in a reduction in lung elastic recoil 27,28 . For example, a cross‐sectional population‐based study in the UK found an association between carotid augmentation index and reduced lung function (FEV 1 ) in 11‐year‐old children who were born preterm 10 .…”

Does Poorer Pulmonary Function Accelerate Arterial Stiffening?

“…Prior observational studies, including 2 prospective studies, 8,9 showed inconsistent associations between pulmonary function and arterial stiffness, as measured by pulse wave velocity (PWV). 8–14 Longitudinal changes in PWV in relation to pulmonary function are unclear, and it remains unknown how spirometrically-defined pulmonary function and its change affect later PWV.…”