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

Authors: 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; Talavera, Gregory A; Lash, James P; Cai, Jianwen; Franceschini, Nora

Published In Am J Hypertens, (2021 03 11)

Abstract: 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.

PubMed ID: 32968788

MeSH Terms: Adolescent; Adult; Aged; Follow-Up Studies; Hispanic or Latino*/statistics & numerical data; Humans; Hypertension*/ethnology; Incidence; Middle Aged; Risk Factors; Smoking*/adverse effects; Smoking*/ethnology; Young Adult