Increased incidence of myocardial infarction and stroke in hypertensive men with reduced lung function

Background and objective Although hypertension is associated with increased cardiovascular risk, many individuals remain free from disease. This study is aimed to investigate whether this variation in individual susceptibilit y is associated with lung function. Design population-based prospective cohort study. Participants 'Men born in 1914', Malmo, Sweden. Subjects (n = 639) were examined and considered free from prevalent cardiov ascular disease at age 55 years. Main outcome measures Mortality, fatal and non-fatal stroke and cardiac events (fatal or non-fatal myocardial infarct ion) during 28-years follow-up. Results Of the men, 467 had normal blood pressure and 172(27%) had hyperten sion (greater than or equal to 160/95 mmHg or treatment for hypertension). Hypertensive men with height-adjusted forced expiratory volume during 1 s ( FEV1,0) below median had significantly higher rates of stroke (13.4 versus 5.8/1000 person-years), cardiac events (27.1 versus 12.8/1000 person-years) and all cause mortality (52.5 versus 28.6/1000 person-years) than hyperten sive men with high FEV1,0. These differences remained statistically signifi cant after adjustment for potential confounders. Men with normal blood pres sure and FEV1.0 below median had higher rates of stroke (5.4 versus 4.2/100 0 person-years), cardiac events (13.3 Versus 11:.6/1000 person-years) and a ll cause mortality (29.9 versus 21.2/1000 person-years) than men with norma l blood pressure and high FEV1.0. After adjustments for potential confounde rs, FEV1.0 was significantly associated with mortality among men with norma l blood pressure, whereas the associations with stroke and cardiac events d id not reach significance. Conclusion The incidence of cardiovascular disease and death associated wit h hypertension is increased among men with reduced lung function. The syner gistic interaction between hypertension and lung function was independent o f smoking and other potential confounders. (C) 2001 Lippincott Williams & W ilkins.