University of Babylon Discusses Evaluation of Pulmonary Function in Hypertensive Patients
The Department of Physiology at the College of Medicine, University of Babylon, discussed the master’s thesis of student Zahraa Hamed Alawi, titled:
“Evaluation of Pulmonary Function in Hypertensive Patients and Its Association with Echocardiographic Parameters,”
supervised by Asst. Prof. Dr. Ahlam Kazem Aboud and Prof. Dr. Uday Jasim Al-Salihi.
The defense was attended by Asst. Prof. Dr. Ashraf Mohammed Ali Hussein (Scientific Assistant Dean), several faculty members, and postgraduate students.
During her defense, the researcher explained that systemic arterial hypertension is one of the major modifiable risk factors for cardiovascular disease and that its impact extends to other organs such as the kidneys and the central nervous system, making it essential to evaluate its effects on pulmonary function.
Left ventricular diastole refers to the phase during which the left ventricle fills with blood, reflecting the heart’s ability to accommodate blood without excessive pressure. Hypertension significantly contributes to left ventricular diastolic dysfunction (LVDD), a condition characterized by the inability of the left ventricle to relax and fill adequately. Chronic hypertension increases afterload, resulting in myocardial hypertrophy and stiffening of the ventricular walls over time. This stiffening adversely affects diastolic function, leading to elevated filling pressures and reduced cardiac efficiency.
Patients with hypertension often exhibit impaired left ventricular relaxation, even in the absence of systolic dysfunction, as documented in several clinical studies. These patients show characteristic changes in left ventricular filling dynamics. Reduced diastolic compliance of the left ventricle—due to structural or functional causes—leads to increased left ventricular filling resistance and elevated wedge pressures, including those in the left atrium, pulmonary veins, and pulmonary capillaries. This can result in interstitial fluid accumulation, causing dyspnea and chest pain.
The study aimed to evaluate the impact of hypertension on pulmonary function and to clarify these effects through correlation studies using echocardiographic measurements and spirometry parameters.
Methodology:
Echocardiographic assessment was performed for each participant, measuring both systolic and diastolic left ventricular parameters. Pulmonary function tests were conducted using spirometry to measure FVC, FEV1, FEV1/FVC, PEFR, and FEF50%. Results were compared between hypertensive patients and a control group, and correlation studies were performed.
Key Findings:
• Pulmonary function parameters were significantly lower in hypertensive patients compared to controls, particularly PEFR and FEF50%.
• Diastolic function parameters of the left ventricle were also reduced in the hypertensive group.
• There was a negative correlation between systolic/diastolic blood pressure and BMI with FVC, FEV1, and FEF50%, although it was not statistically significant (p > 0.05).
• A statistically significant negative correlation was found between systolic/diastolic blood pressure and PEFR (p < 0.05).
• A positive correlation was observed between blood pressure, BMI, and FEV1/FVC ratio.
• Negative correlations were also found between pulmonary function parameters and echocardiographic measures of left ventricular diastolic function (E/A, E/e?, LAV, LAVI, TR velocity), as well as left ventricular mass (LVM) and left ventricular mass index (LVMI), though these were not statistically significant.
Conclusion:
The study concluded that hypertension has a measurable impact on pulmonary function, which may be linked to alterations in left ventricular diastolic performance. This highlights the importance of assessing lung function in hypertensive patients as part of comprehensive cardiovascular risk management.