TY - JOUR
T1 - Current Smoking Raises Risk of Incident Hypertension
T2 - Hispanic Community Health Study-Study of Latinos
AU - Kaplan, Robert C.
AU - Baldoni, Pedro L.
AU - Strizich, Garrett M.
AU - Pérez-Stable, Eliseo J.
AU - Saccone, Nancy L.
AU - Peralta, Carmen A.
AU - Perreira, Krista M.
AU - Gellman, Marc D.
AU - Williams-Nguyen, Jessica S.
AU - Rodriguez, Carlos J.
AU - Lee, David J.
AU - Daviglus, Martha
AU - Talavera, Gregory A.
AU - Lash, James P.
AU - Cai, Jianwen
AU - Franceschini, Nora
N1 - Publisher Copyright:
© 2020 American Journal of Hypertension, Ltd 2020. All rights reserved. For Permissions, please email: [email protected].
PY - 2021/2/1
Y1 - 2021/2/1
N2 - 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.
AB - 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.
KW - blood pressure
KW - chronic kidney disease
KW - epidemiology
KW - hypertension
KW - longitudinal study
KW - prospective cohort study
KW - smoking
UR - http://www.scopus.com/inward/record.url?scp=85102910142&partnerID=8YFLogxK
U2 - 10.1093/ajh/hpaa152
DO - 10.1093/ajh/hpaa152
M3 - Article
C2 - 32968788
AN - SCOPUS:85102910142
SN - 0895-7061
VL - 34
SP - 190
EP - 197
JO - American Journal of Hypertension
JF - American Journal of Hypertension
IS - 2
ER -