Association between hypertension and impaired lung function among adults: A systematic review and meta-analysis

Clinical Snapshot

Key Findings

• P Value: Not reported in abstract but CIs exclude null

• Effect Size: Adjusted OR 1.40 (lung impairment→hypertension); Adjusted OR 1.94 (hypertension→lung impairment)

• Primary Outcome: Bidirectional association between impaired lung function and hypertension

• Nnt Or Sensitivity: Restrictive lung impairment shows stronger association with hypertension than obstructive patterns

• Confidence Interval: 95% CI: 1.31-1.49 and 95% CI: 1.51-2.50 respectively

Clinical Application

Routine spirometry and blood pressure monitoring already standard in Australian primary care Aligns with RACGP guidelines for cardiovascular risk assessment and chronic disease management; relevant for PBS-subsidised medications for both conditions Australian adults with either hypertension or impaired lung function, particularly relevant for chronic disease management

Abstract

BACKGROUND: Impaired lung function and hypertension are both significant global public health concerns, and their potential association has recently drawn considerable interest. This systematic review and meta-analysis aims to investigate the association between impaired lung function and hypertension, and vice versa. METHODS: We searched CINAHL (EBSCOhost), MEDLINE (PubMed), Scopus and Web of Science up to 22nd July 2025 for observational studies involving adults (≥ 18 years) reporting hypertension and impaired lung function. Grey literature was also searched, and data extraction was verified independently. The review was registered with PROSPERO (CRD42023427631). Random effects models estimated pooled ORs with 95% CIs. Subgroup analysis and meta-regression were performed to identify potential sources of heterogeneity. Quality assessment was conducted using Newcastle-Ottawa Scale and JBI checklist and publication bias were appraised. RESULTS: This systematic review included 28 articles, of which 26 articles were selected for the meta-analysis. Of these, 17 studies (n = 134823) examined impaired lung function as the exposure, while 9 studies (n = 12522) investigated hypertension as the exposure. Our findings revealed that the pooled unadjusted effect of lung function impairment on hypertension was 1.70 (95% CI: [1.53-1.88]), while the pooled adjusted effect was lower at 1.40 (95% CI: [1.31-1.49]). In contrast, the pooled unadjusted effect of hypertension on lung impairment was 3.00 (95% CI: [1.86-4.82]), but the pooled adjusted effect decreased to 1.94 (95% CI: [1.51-2.50]). The findings indicate that obstructive, restrictive and mixed lung function impairments are significantly associated with hypertension. Restrictive lung impairment consistently shows a stronger association with hypertension compared to obstructive impairment when impaired lung function is the exposure. CONCLUSION: This study concludes that there is a significant positive association between impaired lung function and hypertension in both directions, with stronger temporal evidence suggesting that impaired lung function may precede hypertension, while the reverse causal direction lacks such evidence.

References

1. 1.Lekamge, D., Kasturiratne, A., Mridha, M. K., & Chambers, J. (2026). Association between hypertension and impaired lung function among adults: A systematic review and meta-analysis. PLoS One. https://doi.org/10.1371/journal.pone.0346569