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Fig 1.

PRISMA flow diagram of systematic review and meta-analysis.

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Table 1.

Characteristics of the 17 included observational studies with hypertension as the outcome.

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Table 2.

Characteristics of the 11 included observational studies with impaired lung function as the outcome.

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Table 3.

Risk of bias summary for the cohort and case-control studies with impaired lung function as the exposure.

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Table 3 Expand

Table 4.

Risk of bias summary for the cross-sectional studies with impaired lung function as the exposure.

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Table 5.

Risk of bias summary for the case-control studies with hypertension as the exposure.

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Table 6.

Risk of bias summary for the cross-sectional studies with hypertension as the exposure.

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Table 6 Expand

Fig 2.

Forest plot showing the association between impaired lung function and hypertension among adults when using impaired lung function as the exposure and hypertension as the outcome (using unadjusted odds ratios).

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Fig 2 Expand

Fig 3.

Funnel plot for the studies with crude (unadjusted) ORs for impaired lung function as the exposure and hypertension as the outcome.

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Fig 3 Expand

Fig 4.

Funnel plot with the regression line for the studies with crude (unadjusted) ORs for impaired lung function as the exposure and hypertension as the outcome.

The points are not symmetrically distributed around the regression line.

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Fig 4 Expand

Fig 5.

Trim-and-fill funnel plot for the studies with crude (unadjusted) ORs for impaired lung function as the exposure and hypertension as the outcome.

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Fig 5 Expand

Fig 6.

Forest plot showing the association between impaired lung function and hypertension among adults when using impaired lung function as the exposure and hypertension as the outcome (using adjusted odds ratios).

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Fig 6 Expand

Fig 7.

Funnel plot for the studies with adjusted ORs for impaired lung function as the exposure and hypertension as the outcome.

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Fig 7 Expand

Fig 8.

Funnel plot with the regression line for the studies with adjusted ORs for impaired lung function as the exposure and hypertension as the outcome.

The points are symmetrically distributed around the regression line.

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Fig 8 Expand

Fig 9.

Trim-and-fill funnel plot for the studies with adjusted ORs for impaired lung function as the exposure and hypertension as the outcome.

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Fig 9 Expand

Fig 10.

Forest plot showing the association between hypertension and impaired lung function among adults when using hypertension as the exposure (using unadjusted odds ratios).

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Fig 10 Expand

Fig 11.

Funnel plot for the studies with crude (unadjusted) ORs for hypertension as the exposure and impaired lung function as the outcome.

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Fig 11 Expand

Fig 12.

Funnel plot with the regression line for the studies with crude (unadjusted) ORs for hypertension as the exposure and impaired lung function as the outcome.

The points are not symmetrically distributed around the regression line.

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Fig 12 Expand

Fig 13.

Trim-and-fill funnel plot for the studies with crude (unadjusted) ORs for hypertension as the exposure and impaired lung function as the outcome.

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Fig 13 Expand

Table 7.

Summary of bidirectional associations between impaired lung function and hypertension.

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Table 7 Expand

Fig 14.

Forest plot showing the association between hypertension and impaired lung function among adults when using hypertension as the exposure (using adjusted odds ratios).

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Fig 14 Expand

Fig 15.

Funnel plot for the studies with adjusted ORs for hypertension as the exposure and impaired lung function as the outcome.

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Fig 15 Expand

Fig 16.

Trim-and-fill funnel plot for the studies with adjusted ORs for hypertension as the exposure and impaired lung function as the outcome.

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Fig 16 Expand

Fig 17.

The relationship between impaired lung function and hypertension.

Leave-one-out sensitivity analysis of the unadjusted ORs – ILF (exposure) and HT (outcome).

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Fig 17 Expand

Fig 18.

The relationship between impaired lung function and hypertension.

Leave-one-out sensitivity analysis of the adjusted ORs - ILF (exposure) and HT (outcome).

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Fig 18 Expand

Fig 19.

The relationship between hypertension and impaired lung function.

Leave-one-out sensitivity analysis of the unadjusted ORs – HT (exposure) and ILF (outcome).

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Fig 19 Expand

Fig 20.

Forest plot for subgroup analyses by study design (unadjusted ORs): impaired lung function as the exposure and hypertension as the outcome.

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Fig 21.

Forest plot for subgroup analyses by country (unadjusted ORs): impaired lung function as the exposure and hypertension as the outcome.

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Fig 22.

Forest plot for subgroup analyses by lung function impairment type (unadjusted ORs): impaired lung function as the exposure and hypertension as the outcome.

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Fig 23.

Forest plot for subgroup analyses by study design (adjusted ORs): impaired lung function as the exposure and hypertension as the outcome.

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Fig 23 Expand

Fig 24.

Forest plot for subgroup analyses by lung function impairment type (adjusted ORs): impaired lung function as the exposure and hypertension as the outcome.

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Fig 25.

Forest plot for subgroup analyses by country (adjusted ORs): impaired lung function as the exposure and hypertension as the outcome.

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Fig 26.

Forest plot for subgroup analyses by study design (unadjusted ORs): hypertension as the exposure.

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Fig 27.

Forest plot for subgroup analyses by country (unadjusted ORs): hypertension as the exposure.

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Fig 28.

Forest plot for subgroup analyses by continent (unadjusted ORs): hypertension as the exposure.

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Fig 29.

Forest plot for subgroup analyses by lung function impairment type (unadjusted ORs): hypertension as the exposure.

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Fig 30.

Forest plot for subgroup analyses by country (adjusted ORs): hypertension as the exposure.

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Fig 30 Expand

Fig 31.

Forest plot for subgroup analyses by continent (adjusted ORs): hypertension as the exposure.

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Fig 31 Expand

Fig 32.

Forest plot for subgroup analyses by lung function impairment type (adjusted ORs): hypertension as the exposure.

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Table 8.

Results of the univariate meta-regression with impaired lung function as the exposure.

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Table 8 Expand

Table 9.

Results of the multivariable meta-regression: significant moderators from univariate analysis (exposure: impaired lung function).

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Fig 33.

Pathophysiology of hypertension leading to CVD in patients with impaired lung function [73].

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Fig 33 Expand