Objectives: To determine whether elevated blood pressure influences risk for respiratory infection. Design: Prospective, population-based epidemiological and Mendelian randomisation studies. Setting: UK Biobank. Participants: 377,143 self-identified British descent (54% women; median age 58 years) participants in the UK Biobank. Main outcome measures: First incident pneumonia over an average of 8 follow-up years. Results: 107,310 (30%) participants had hypertension at UK Biobank enrolment, and 9,969 (3%) developed a pneumonia during follow-up. Prevalent hypertension at baseline was significantly associated with increased risk for incident respiratory disease including pneumonia (hazard ratio 1.36 (95% confidence interval 1.29 to 1.43), P<0.001), acute respiratory distress syndrome or respiratory failure (1.43 (1.29 to 1.59), P<0.001), and chronic lower respiratory disease (1.30 (1.25 to 1.36), P<0.001), independent of age, age2, sex, smoking status, BMI, prevalent diabetes mellitus, prevalent coronary artery disease, and principal components of ancestry. Mendelian randomisation analyses indicated that genetic predisposition to a 5 mmHg increase in blood pressure was associated with increased risk of incident pneumonia for SBP (1.08, (1.04 to 1.13), P<0.001) and DBP (1.11 (1.03 to 1.20), P=0.005). Additionally, consistent with epidemiologic associations, increase in blood pressure genetic risk was significantly associated with reduced forced expiratory volume in the first second, forced vital capacity, and the ratio of the two (P<0.001 for all). Conclusions: These results strongly suggest that elevated blood pressure independently increases risk for pneumonia and reduces pulmonary function. Maintaining adequate blood pressure control, in addition to other measures, may reduce risk for pneumonia. Whether the present findings are generalizable to novel coronavirus disease 2019 (COVID-19) require further study.

中文翻译：

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血压对肺炎风险的影响：英国生物库中的流行病学关联和孟德尔随机化

目的：确定血压升高是否会影响呼吸道感染的风险。设计：前瞻性，基于人群的流行病学和孟德尔随机研究。地点：英国生物库。参与者：英国生物库中的377,143名自我识别的英国血统（女性占54％；中位年龄58岁）。主要结果指标：平均8年的随访中首次发生肺炎。结果：107,310（30％）名参与者在UK Biobank入学时患有高血压，而9,969名（3％）在随访期间发生了肺炎。基线时的普遍高血压与包括肺炎（危险比1.36（95％置信区间1.29至1.43），P <0.001），急性呼吸窘迫综合征或呼吸衰竭（1.43（1.29至1.59））的突发呼吸道疾病风险增加显着相关， P <0.001），和慢性下呼吸道疾病（1.30（1.25至1.36），P <0.001），与年龄，年龄2，性别，吸烟状况，BMI，流行的糖尿病，流行的冠状动脉疾病和血统的主要成分无关。孟德尔随机分析表明，遗传易感性血压升高5 mmHg与SBP（1.08，（1.04至1.13），P <0.001）和DBP（1.11（1.03至1.20），P = 0.005）。此外，与流行病学关联一致，血压遗传风险的增加与头一秒钟的强制呼气量减少，强制肺活量以及两者的比率显着相关（所有P均<0.001）。结论：这些结果强烈表明，血压升高独立增加了肺炎的风险并降低了肺功能。除其他措施外，保持适当的血压控制可能会降低肺炎的风险。目前的发现是否可推广到2019年新的冠状病毒疾病（COVID-19）需要进一步研究。