Citation
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. (2021). Current Smoking Raises Risk of Incident Hypertension: Hispanic Community Health Study - Study of Latinos. American Journal of Hypertension, 34(2), 190-197. PMCID: PMC7951044Abstract
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.
URL
http://dx.doi.org/10.1093/ajh/hpaa152Reference Type
Journal ArticleYear Published
2021Journal Title
American Journal of HypertensionAuthor(s)
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