Current Smoking Raises Risk of Incident Hypertension: Hispanic Community Health Study-Study of Latinos

Robert C. Kaplan, Pedro L. Baldoni, Garrett M. Strizich, Eliseo J. Pérez-Stable, Nancy L. Saccone, Carmen A. Peralta, Krista M. Perreira, Marc D. Gellman, Jessica S. Williams-Nguyen, Carlos J. Rodriguez, David J. Lee, Martha Daviglus, Gregory A. Talavera, James P. Lash, Jianwen Cai, Nora Franceschini

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18 Scopus citations


Background: Hypertension has been implicated as a smoking-related risk factor for cardiovascular disease but the dose-response relationship is incompletely described. Hispanics, who often have relatively light smoking exposures, have been understudied in this regard. Methods: We used data from a 6-year follow-up study of US Hispanic adults aged 18-76 to address the dose-response linking cigarette use with incident hypertension, which was defined by measured blood pressure above 140/90 mm Hg or initiation of antihypertensive medications. Adjustment was performed for potential confounders and mediators, including urinary albumin-to-creatinine ratio which worsened over time among smokers. Results: Current smoking was associated with incident hypertension, with a threshold effect above 5 cumulative pack-years of smoking (vs. never smokers, hazard ratio for hypertension [95% confidence interval] of 0.95 [0.67, 1.35] for 0-5 pack-years, 1.47 [1.05, 2.06] for 5-10 pack-years, 1.40 [1.00, 1.96] for 10-20 pack-years, and 1.34 [1.09, 1.66] for ≥20 pack-years, P = 0.037). In contrast to current smokers, former smokers did not appear to have increased risk of hypertension, even at the highest cumulative pack-years of past exposure. Conclusions: The results confirm that smoking constitutes a hypertension risk factor in Hispanic adults. A relatively modest cumulative dose of smoking, above 5 pack-years of exposure, raises risk of hypertension by over 30%. The increased hypertension risk was confined to current smokers, and did not increase further with higher pack-year levels. The lack of a smoking-hypertension association in former smokers underscores the value of smoking cessation.

Original languageEnglish
Pages (from-to)190-197
Number of pages8
JournalAmerican Journal of Hypertension
Issue number2
StatePublished - Feb 1 2021


  • blood pressure
  • chronic kidney disease
  • epidemiology
  • hypertension
  • longitudinal study
  • prospective cohort study
  • smoking


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