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


Kaplan, Robert C.; Baldoni, Pedro L.; Strizich, Garrett M.; Pérez-Stable, Eliseo J.; Saccone, Nancy L.; Peralta, Carmen A.; Perreira, Krista M.; Gellman, Marc D.; Williams-Nguyen, Jessica S.; & Rodriguez, Carlos J., et al. (Online ahead of print). Current Smoking Raises Risk of Incident Hypertension: Hispanic Community Health Study - Study of Latinos. American Journal of Hypertension.


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 six-year follow up study of US Hispanic adults aged 18 to 76 to address the dose-response linking cigarette use with incident hypertension, which was defined by measured blood pressure above 140 / 90 mmHg 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 five cumulative pack-years of smoking (versus 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.


Reference Type

Journal Article

Article Type


Year Published

Online ahead of print

Journal Title

American Journal of Hypertension


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

Data Set/Study



United States of America