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Gu H, Hao L, Li M, Li J. Joint effect of overweight/obesity and tobacco exposure on hypertension in children aged 6-17 years: a cross-sectional study. Front Pediatr 2023; 11:1188417. [PMID: 37456569 PMCID: PMC10347524 DOI: 10.3389/fped.2023.1188417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Accepted: 06/14/2023] [Indexed: 07/18/2023] Open
Abstract
Aim To assess the individual effects of overweight/obesity and tobacco exposure, and their combined effects on hypertension in children. Methods This cross-sectional study included 6,339 children aged 6-17 years from National Health and Nutrition Examination Surveys 1999-2018. Participants' height, weight and blood pressure (BP) were measured by trained technicians. Hypertension was defined as: mean systolic BP (SBP) and/or diastolic BP (DBP) ≥ 90th percentile for sex, age, and height (for children aged 1-13 years), and SBP ≥120 mmHg and/or a DBP ≥80 mmHg (for adolescents aged 13-17 years); or self-reported having been diagnosed with hypertension or taking antihypertensive medication. Gender- and age-specific body mass index (BMI) cut-points were used to define overweight/obesity: "overweight" was defined as a BMI > 1 standard deviation (SD); "obesity" was defined as BMI > 2SD; and "thinness" was defined as BMI < -2SD. Tobacco exposure was defined as having serum cotinine levels >0.05 µg/L or reporting the presence of at least one smoker in the household. Weighted univariate and multivariate logistic regression models were used to assess overweight/obesity and tobacco exposure with the odds of hypertension, and the combined effects of overweight/ obesity and tobacco exposure on hypertension, followed by strata-specific analyses. Odds ratios (OR) with 95% confidence intervals (CI) were calculated. Results The prevalence of overweight/obesity and tobacco exposure was significantly higher in the hypertension group than in the non-hypertension group. Overweight/obesity (OR = 1.67, 95%CI: 1.26-2.21/ OR = 2.38, 95%CI: 1.67-3.39) and tobacco exposure (OR = 1.58, 95%CI: 1.16-2.14) were associated with a higher odd of hypertension in children, respectively. Additionally, we also observed the combined effect between overweight (OR = 3.05, 95%CI: 1.96-4.75)/obesity (OR = 3.68, 95%CI: 2.24-6.03) and tobacco exposure were related to hypertension odds in children, with a significant effect in different populations. Conclusion There may exist joint effect of overweight/obesity and tobacco exposure on the odds of hypertension in American children. These findings offer an insight that early weight control and reduction of tobacco exposure may be important to reduce odds of hypertension in children.
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Affiliation(s)
- Huan Gu
- Department of Integrative Cardiology, China-Japan Friendship Hospital, Beijing, China
| | - Long Hao
- Department of Pediatrics, Beijing Fangshan District Liangxiang Hospital, Beijing, China
| | - Mingxi Li
- Department of Pediatrics, Guang’ Anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Ji Li
- Department of Pediatrics, Guang’ Anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
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Maternal smoking in pregnancy and blood pressure during childhood and adolescence: a meta-analysis. Eur J Pediatr 2023; 182:2119-2132. [PMID: 36823476 PMCID: PMC10175379 DOI: 10.1007/s00431-023-04836-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 01/12/2023] [Accepted: 01/20/2023] [Indexed: 02/25/2023]
Abstract
UNLABELLED Arterial hypertension during childhood or adolescence is rising, and smoking during pregnancy may constitute a modifiable risk factor. This study aims to evaluate the effect of maternal smoking during pregnancy on diastolic (DBP) and systolic blood pressure (SBP) in childhood and adolescence. A bibliographic search was conducted in PubMed, Embase, and CENTRAL databases in March 2022. Meta-analysis was performed with the difference in mean-adjusted SBP/DBP of children and adolescents aged 3-17 years, according to maternal smoking/non-smoking in pregnancy. A random effects model was applied; a leave-one-out analysis and meta-analysis by subgroups were performed. A modified Newcastle-Ottawa scale was used to assess the quality of the studies. Evidence levels were rated using the GRADE system. Fifteen studies were included in the meta-analysis; all of them evaluated the mean-adjusted SBP difference in children or adolescents (N = 73,448), and 6 also that of DBP (N = 31,459). Results showed that maternal smoking during pregnancy significantly increased SBP (β = 0.31 mmHg 95% CI 0.14-0.49). A greater increase in mean-adjusted SBP was observed in those studies that completed the recruitment before 1990, were conducted in non-European countries, used standard mercury or manual sphygmomanometry, adjusted for birth weight, and were in the lowest quality subgroup. No significant association was found for DBP. The GRADE level of evidence was low for SBP and very low for DBP. CONCLUSION Smoking in pregnancy might increase SBP in childhood and adolescence. Due to the low level of evidence, solid inferences cannot be drawn about the clinical relevance of these findings. WHAT IS KNOWN • AHT is the leading cause of premature death among adults worldwide. • Deleterious effects derived from SHS exposure on children's health have been documented since early 1970. To date, there are contradictory results about the effects of prenatal SHS exposure on children's BP. WHAT IS NEW • Smoking in pregnancy may increase SBP during childhood and adolescence. • Maternal smoking during pregnancy could have greater influence on their offspring's SBP than on DBP.
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Agostinis-Sobrinho C, Kievisiene J, Dubey V, Rauckiene-Michealsson A, Norkiene S, Ramirez-Velez R, Reuter CP, Brand C, Mota J, Santos R. Cardiovascular health behavior and blood pressure in adolescents: A longitudinal analysis. Nutr Metab Cardiovasc Dis 2022; 32:1766-1773. [PMID: 35599087 DOI: 10.1016/j.numecd.2022.04.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 04/01/2022] [Accepted: 04/11/2022] [Indexed: 11/15/2022]
Abstract
BACKGROUND The ideal cardiovascular health behaviors (ICHB) have been associated with a subsequent positive health status in adults. However, evidence regarding blood pressure (BP) and ICHB in adolescents is scarce. The aim of this prospective cohort was to evaluate the impact of accumulation of ICHB on BP values in adolescents over two years. METHODS This is a longitudinal analysis with 445 adolescents (232 girls) aged 12-18 years old. Resting blood pressure was measured at baseline and 2 years later, and ICHBs at baseline according to standard procedures. Based on the American Heart Association definition, the ICHB index was defined as a sum of meeting the ICHBs (from 0 to 4, where 4 would be the healthiest profile of all ICHBs) for a healthy diet, physical activity, smoking status and body mass index. RESULTS Adjusted means values (ANCOVA) of BP parameters through achievement of a greater number of (between 1-4) the ICHBs (adjusting for potential confounders, age, sex, pubertal stage and socioeconomic status) showed that, as increase the number of ICHB accumulated as a lower the BP levels [ICHB and SBP (F3.435) = 4.501, p = 0.004), DBP (F(3.435) = 2.725, p = 0.044), pulse pressure (F(3.435) = 4.004, p = 0.008), and rate pressure product (F(3.435) = 2.866, p = 0.036)] over two years. CONCLUSION A lower number of ICHB (smoking status, body mass index, physical activity, and diet) during adolescence play a key role on blood pressure over two years. A higher number of ICHB is seen to be associated with a lower risk of short-term, hypertension.
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Affiliation(s)
| | | | - Viney Dubey
- Faculty of Health Sciences, Klaipeda University, Klaipeda, Lithuania
| | | | - Sigute Norkiene
- Faculty of Health Sciences, Klaipeda University, Klaipeda, Lithuania
| | - Robinson Ramirez-Velez
- Navarrabiomed, Hospital Universitario de Navarra (HUN), Navarra Institute for Health, Research (IdiSNA), Universidad Pública de Navarra (UPNA), Pamplona, Spain; Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain
| | - Cezane Priscila Reuter
- Graduate Program in Health Promotion, University of Santa Cruz Do Sul, Santa Cruz Do Sul, RS, Brazil
| | - Caroline Brand
- Graduate Program in Health Promotion, University of Santa Cruz Do Sul, Santa Cruz Do Sul, RS, Brazil
| | - Jorge Mota
- Research Centre in Physical Activity, Health and Leisure, Faculty of Sport, University of Porto, Portugal
| | - Rute Santos
- Research Centre in Physical Activity, Health and Leisure, Faculty of Sport, University of Porto, Portugal
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Agbonlahor O, Rai J, Mattingly D, Hart J, Walker K. Cardiovascular disease risk perceptions and tobacco use among Appalachian youth. POPULATION MEDICINE 2021. [DOI: 10.18332/popmed/143749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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5
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Alcohol and tobacco influencing prevalence of hypertension among 15–54 years old Indian men: An application of discriminant analysis using National Family Health Survey (NFHS), 2015–16. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2021. [DOI: 10.1016/j.cegh.2021.100894] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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6
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Zhang H, Yu L, Wang Q, Tao Y, Li J, Sun T, Zhang Y, Zhang H. In utero and postnatal exposure to environmental tobacco smoke, blood pressure, and hypertension in children: the Seven Northeastern Cities study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2020; 30:618-629. [PMID: 31140839 DOI: 10.1080/09603123.2019.1612043] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Accepted: 04/22/2019] [Indexed: 06/09/2023]
Abstract
To evaluate the association of environmental tobacco smoke (ETS) exposure with hypertension and blood pressure (BP) in children, a sample of 9,354 children, aged 5-17 years, was studied from seven northeastern cities of China in 2012-2013. The results showesd that significant associations were observed for hypertension with ETS exposure in utero [odds ratio (OR) 1.36, 95% confidence interval (CI) 1.18-1.57], with current major ETS exposure from fathers (1.38, 1.21-1.57) or anyone (1.26, 1.12-1.42), and with intensity of ETS exposure greater than 1 cigarette per day (ORs ranged from 1.20 to 1.35). For SBP, significant associations were only observed in children with major ETS exposure from father and with cigarettes smoking >10/day. When stratified by sex, more significant associations were found in girls than in boys. In conclusion, prenatal and postnatal ETS exposure was significantly associated with increased odds of hypertension in children, especially in girls.
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Affiliation(s)
- Haishan Zhang
- Department of Cardiology, the First Affiliated Hospital of China Medical University , Shenyang, China
| | - Lujiao Yu
- Department of Geriatrics, the First Affiliated Hospital of China Medical University , Shenyang, China
| | - Qi Wang
- Department of Geriatrics, the First Affiliated Hospital of China Medical University , Shenyang, China
| | - Ye Tao
- Department of Geriatrics, the First Affiliated Hospital of China Medical University , Shenyang, China
| | - Jing Li
- Department of Geriatrics, the First Affiliated Hospital of China Medical University , Shenyang, China
| | - Tingting Sun
- Department of Geriatrics, the First Affiliated Hospital of China Medical University , Shenyang, China
| | - Yousheng Zhang
- General Hospital of Northern Theater Command, Liaoning Provincial Military Clinic , Shenyang, China
| | - Haiyan Zhang
- Department of Geriatrics, the First Affiliated Hospital of China Medical University , Shenyang, China
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Castner J, Amiri A, Huntington-Moskos L. Applying the NIEHS translational research framework (NIEHS-TRF) to map clinical environmental health research trajectories. Nurs Outlook 2020; 68:301-312. [PMID: 32273105 PMCID: PMC9875864 DOI: 10.1016/j.outlook.2020.01.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2019] [Revised: 12/20/2019] [Accepted: 01/02/2020] [Indexed: 01/27/2023]
Abstract
Background: There is a need for comprehensive planning tools and exemplars for clinical environmental health research programs. The National Institute of Environmental Health Sciences Translational Research Framework (NIEHS-TRF), as a comprehensive research activity mapping framework, promises to fill this gap in program planning and communication tools. Objective: The objective is a proof of concept demonstration to apply the NIEHS-TRF as a research project and career trajectory cartography framework. Methods: We utilized case series examples to apply the NIEHS-TRF as a project/career cartography framework. After a tailored research mission statement is clarified, the four step process in the NIEHS-TRF application includes 1) identifying research categories and activities (depicted visually by rings/nodes) that link to research program deliverables, 2) within each category (visual ring), linking specific works and program outcomes to activities (visual nodes), 3) coherently depicting visually as an overall map, and 4) developing recommended improvements for the NIEHS-TRF for research program cartography utility. Results: Successful mapping of a research project plan in a training grant application, a summary of an individual trajectory of research, and a community-initiated project was completed with mapping visualizations. The exercise facilitated purposeful planning and communication to describe common translational goals, progress, and targeted need for interdisciplinary collaboration. Discussion: Utilizing the NIEHS-TRF as a mapping tool for research program planning enabled unique insights into strengths, gaps, collaboration opportunities, and applications for environmental health nursing. This research project, career, and community-initiated research program trajectory mapping communication tool promises to accelerate impact and advancement through purposeful and clear planning for ongoing research activities along the translational continuum.
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Affiliation(s)
| | - Azita Amiri
- College of Nursing, University of Alabama in Huntsville, Huntsville, Alabama, USA
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Alomari MA, Al-Sheyab NA, Mokdad AH. Gender-Specific Blood Pressure and Heart Rate Differences in Adolescents Smoking Cigarettes, Waterpipes or Both. Subst Use Misuse 2020; 55:296-303. [PMID: 31556788 DOI: 10.1080/10826084.2019.1666146] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Background: The effect of concurrent cigarette and waterpipe (i.e. both) smoking on cardiovascular function is still a scarce, especially among adolescents. Objective: Therefore, the study aimed at comparing cardiovascular measures among adolescents smoking cigarettes, waterpipe, or both, versus never smoking. Methods: Self-reported smoking status and cardiovascular measures were obtained from 771 boys (n = 475) and girls (n = 296) in the 7th-10th grade. Results: Stepwise regression showed that smoking explained (p < .05) 4.8% of heart rate, 6.1% of diastolic blood pressure, 3.9% of mean arterial pressure, 2.8% of pulse pressure, and 4.0% of rate pressure products. The gender-stratified one-way (4 smoking group) ANCOVA revealed greater (p < .05) heart rate and diminished (p < .05) diastolic blood pressure, mean arterial pressure, and rate pressure product in the boys smoking cigarettes, waterpipe, or both versus the ones never smoked, but not in the girls. No differences (p > .05) were found between the smoking groups (cigarettes, waterpipe, versus both). Conclusions: The study indicates that cardiovascular measures are equally altered among the boys, but not the girls, smoking cigarettes, waterpipe, or both as compared to the ones never smoked.
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Affiliation(s)
- Mahmoud A Alomari
- Division of Physical Education, Department Educational Sciences, Qatar University, Doha, Qatar.,Division of Physical Therapy, Department of Rehabilitation Sciences, Jordan University of Science and Technology, Irbid, Jordan
| | - Nihaya A Al-Sheyab
- Faculty of Applied Medical Sciences, Allied Medical Sciences Department, Jordan University of Science and Technology, Irbid, Jordan.,Faculty of Nursing, Maternal and Child Health Department, Jordan University of Science and Technology, Irbid, Jordan
| | - Ali H Mokdad
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
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Fowokan A, Punthakee Z, Waddell C, Rosin M, Morrison KM, Gupta M, Rangarajan S, Teo K, Lear S. Multifactorial correlates of blood pressure in South Asian children in Canada: a cross-sectional study. BMJ Open 2019; 9:e027844. [PMID: 30962241 PMCID: PMC6500289 DOI: 10.1136/bmjopen-2018-027844] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
OBJECTIVE We sought to explore various correlates of blood pressure (BP) and hypertension, and to identify the most important aggregate combination of correlates for BP in South Asian children. DESIGN Cross-sectional study SETTING: Community-based recruitment in two Canadian cities PARTICIPANTS: South Asian children (n=762) provided a range of physiological, lifestyle and social variables. BP was assessed using an automated device. Body mass index (BMI), waist circumference (WC), waist-to-height ratio (WHtR) and BP were transformed to z-scores using published standards. OUTCOME MEASURES Linear and logistic regression analyses were used to explore associations between the range of variables with BP z-scores and hypertension while stepwise regression was used to identify aggregate factors that provided explanatory capacity for systolic BP (SBP) and diastolic BP (DBP) z-scores. RESULTS A range of variables were associated with BP z-score and hypertension in unadjusted analysis. On adjustment for confounders, the association between age (β=-0.054, 95% CI=-0.078 to 0.029), female sex (β=-0.208, 95% CI=-0.350 to -0.067), height (β=0.022, 95% CI=0.011 to 0.033), weight (β=0.047, 95% CI=0.040 to 0.055), BMI z-score (β=0.292, 95% CI=0.249 to 0.336), WC z-score (β=0.273, 95% CI=0.219 to 0.326), WHtR z-score (β=0.289, 95% CI=0.236 to 0.342), heart rate (β=0.016, 95% CI=0.010 to 0.022), child's perception of body image (β=0.183, 95% CI=0.128 to 0.239) and grip strength (β=0.025, 95% CI=0.007 to 0.043) with SBP z-score remained. In stepwise regression, age, sex, BMI z-score, heart rate and weight accounted for 30% of the variance of SBP z-score, while age, BMI z-score, heart rate and daily fast food intake accounted for 23% of the DBP z-score variance. CONCLUSION Our findings suggest that variables, such as age, sex, height, adiposity and heart rate, provide stronger explanatory capacity to BP variance and hypertension risk than other variables in South Asian children.
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Affiliation(s)
- Adeleke Fowokan
- Department of Biomedical Physiology and Kinesiology, Simon Fraser University, Burnaby, British Columbia, Canada
| | - Zubin Punthakee
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Charlotte Waddell
- Faculty of Health Sciences, Simon Fraser University, Vancouver, British Columbia, Canada
| | - Miriam Rosin
- Department of Biomedical Physiology and Kinesiology, Simon Fraser University, Burnaby, British Columbia, Canada
| | | | - Milan Gupta
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Sumathy Rangarajan
- Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada
| | - Koon Teo
- Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada
| | - Scott Lear
- Faculty of Health Sciences, Simon Fraser University, Vancouver, British Columbia, Canada
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Fowokan AO, Sakakibara BM, Onsel N, Punthakee Z, Waddell C, Rosin M, Lear SA. Correlates of elevated blood pressure in healthy children: a systematic review. Clin Obes 2018; 8:366-381. [PMID: 30066442 DOI: 10.1111/cob.12271] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Revised: 05/22/2018] [Accepted: 05/29/2018] [Indexed: 12/13/2022]
Abstract
The prevalence of hypertension in children is increasing globally. Addressing this will require a robust understanding of associated risk factors. To this end, we conducted a systematic review to identify correlates of elevated blood pressure (BP) in children. Literature searches were conducted using pre-defined search terms from three academic databases. The abstract and full text of identified studies were screened for eligibility by two independent reviewers. A total of 100 studies were included in this systematic review. An assessment tool was first used to assess study quality; a narrative synthesis was then performed. We found a broad range of physiological, social and behavioural factors associated with elevated BP in children. The most common correlate observed was adiposity, suggesting that childhood obesity may be implicated in the increased prevalence of hypertension observed in children. However, the broad range of other factors identified underscores the multi-factorial aetiology of hypertension. Data from a broad range of studies showed that the correlates of hypertension in children are multi-factorial. Therefore, approaches aimed at preventing hypertension must in turn be multi-factorial to ensure that the burden of hypertension in childhood is addressed.
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Affiliation(s)
- A O Fowokan
- Department of Biomedical Physiology and Kinesiology, Simon Fraser University, Burnaby, British Columbia, Canada
| | - B M Sakakibara
- Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
| | - N Onsel
- Department of Industrial Engineering, Boğaziçi University, Istanbul, Turkey
| | - Z Punthakee
- Department of Medicine, McMaster University and Population Health Research Institute, Hamilton, Ontario, Canada
| | - C Waddell
- Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
| | - M Rosin
- Department of Biomedical Physiology and Kinesiology, Simon Fraser University, Burnaby, British Columbia, Canada
| | - S A Lear
- Department of Biomedical Physiology and Kinesiology, Simon Fraser University, Burnaby, British Columbia, Canada
- Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
- Division of Cardiology, Providence Health Care, Vancouver, British Columbia, Canada
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Merianos AL, Jandarov RA, Khoury JC, Mahabee-Gittens EM. Tobacco Smoke Exposure Association With Lipid Profiles and Adiposity Among U.S. Adolescents. J Adolesc Health 2018; 62:463-470. [PMID: 29224987 PMCID: PMC5866739 DOI: 10.1016/j.jadohealth.2017.10.001] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2017] [Revised: 09/13/2017] [Accepted: 10/06/2017] [Indexed: 01/19/2023]
Abstract
PURPOSE We investigated the association between tobacco smoke exposure (TSE) as measured by serum cotinine and lipoprotein cholesterols and adiposity in adolescents. METHODS We performed a secondary analysis of 1999-2012 National Health and Nutrition Examination Survey data including participants 12-19 years old. We examined TSE: unexposed (<.05 ng/mL), passively exposed (.05-2.99 ng/mL), and actively exposed (≥3 ng/mL); lipid profiles: total cholesterol, high-density lipoprotein cholesterol (HDL-C), non-HDL-C, low-density lipoprotein cholesterol (LDL-C), and triglycerides; and adiposity: body mass index z-score (BMIZ), waist circumference (WC), and waist-to-height ratio (WHtR). Covariates were age, sex, race/ethnicity, income, diet, and physical activity. Multiple regression models were used to assess the association between TSE and lipid profile variables separately, and then TSE and adiposity measures separately, adjusting for covariates. We performed logistic regression to examine the association of TSE with body mass index and WHtR classifications. RESULTS Of the 11,550 participants, 41.7% were unexposed to tobacco smoke, 40.5% were passively exposed, and 17.8% were actively exposed. Compared with unexposed, participants with active TSE had lower total cholesterol, lower HDL-C, and higher triglycerides; higher BMIZ, higher WC, and higher WHtR; participants with passive TSE had lower HDL-C, higher total cholesterol, and higher LDL-C; higher BMIZ, higher WC, and higher WHtR. Participants actively exposed were at increased odds of being obese or WHtR ≥.65, and those passively exposed were at increased odds of being overweight, obese, or WHtR ≥.65. CONCLUSIONS Active TSE and passive TSE are differentially associated with factors within the lipid profile and adiposity, independent of covariates. TSE prevention efforts should start as early as childhood and continue throughout adolescence and adulthood.
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Affiliation(s)
- Ashley L Merianos
- School of Human Services, University of Cincinnati, Cincinnati, Ohio.
| | - Roman A Jandarov
- Division of Biostatistics and Bioinformatics, Department of Environmental Health, College of Medicine, University of Cincinnati, Cincinnati, Ohio
| | - Jane C Khoury
- Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, College of Medicine, University of Cincinnati, Cincinnati, Ohio
| | - E Melinda Mahabee-Gittens
- Division of Emergency Medicine, Cincinnati Children's Hospital Medical Center, College of Medicine, University of Cincinnati, Cincinnati, Ohio
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12
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Alomari MA, Al-Sheyab NA. Impact of waterpipe smoking on blood pressure and heart rate among adolescents: The Irbid-TRY. JOURNAL OF SUBSTANCE USE 2017. [DOI: 10.1080/14659891.2017.1394379] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Mahmoud A. Alomari
- Division of Physical Therapy, Department of Rehabilitation Sciences, Jordan University of Science and Technology, Irbid, Jordan
| | - Nihaya A. Al-Sheyab
- Faculty of Nursing, Maternal and Child Health Department, Jordan University of Science and Technology, Irbid, Jordan
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13
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Yang Y, Liu F, Wang L, Li Q, Wang X, Chen JC, Wang Q, Shen H, Zhang Y, Yan D, Zhang M, He Y, Peng Z, Wang Y, Xu J, Zhao J, Zhang Y, Zhang H, Xin X, Wang Y, Liu D, Guo T, Dai Q, Ma X. Association of Husband Smoking With Wife's Hypertension Status in Over 5 Million Chinese Females Aged 20 to 49 Years. J Am Heart Assoc 2017; 6:e004924. [PMID: 28320748 PMCID: PMC5524022 DOI: 10.1161/jaha.116.004924] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2016] [Accepted: 01/27/2017] [Indexed: 11/21/2022]
Abstract
BACKGROUND The effect of second-hand smoking, especially husband smoking, on wife's hypertension has not been well studied. The current study was aimed to assess the association of husband smoking with wife's hypertension among females aged 20 to 49 years. METHODS AND RESULTS This study included 5 027 731 females along with their husbands from the National Free Pre-pregnancy Checkup Projects conducted across 31 provinces in China in 2014. Smoking/passive smoking status was collected by a standard questionnaire and blood pressure was measured by an electronic device after 10 minutes rest. Odds ratios and their corresponding 95% CIs for female hypertension were estimated according to smoking status of husband and wife, husbands' smoking amount, and cumulative exposure to husband smoking. Compared with neither-smoker group, the multivariable-adjusted odds ratio for female hypertension was 1.28 (1.27-1.30), 1.53 (1.30-1.79), and 1.50 (1.36-1.67) in husband-only, wife-only, and mixed group, respectively. Furthermore, a higher risk of having hypertension was associated with amount and cumulative exposure of husband smoking. For example, compared with neither-smoker, the multivariate-adjusted odds ratio was 1.22 (1.19-1.25), 1.24 (1.21-1.26), 1.32 (1.26-1.37), 1.37 (1.34-1.41), and 1.75 (1.64-1.87) for females whose husband smoked 1 to 5, 6 to 10, 11 to 15, 16 to 20, and ≥21 cigarettes per day, respectively (Pfor trend<0.001). Subgroup analyses identified similar results. CONCLUSIONS There were associations of husband smoking with female hypertension prevalence. A family-based smoking restriction strategy may reduce smoking in males and improve hypertension control in females.
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Affiliation(s)
- Ying Yang
- National Research Institute for Family Planning, Beijing, China
- National Human Genetic Resources Center, Beijing, China
| | - Fangchao Liu
- Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Long Wang
- National Research Institute for Family Planning, Beijing, China
- Graduate School of Peking Union Medical College, Beijing, China
| | - Qian Li
- National Research Institute for Family Planning, Beijing, China
- Graduate School of Peking Union Medical College, Beijing, China
| | - Xingyu Wang
- National Research Institute for Family Planning, Beijing, China
- National Human Genetic Resources Center, Beijing, China
- Beijing Hypertension League Institute, Beijing, China
| | - Julia C Chen
- Department of Behavioral and Community Health, School of Public Health, University of Maryland, College Park, MD
| | - Qiaomei Wang
- Graduate School of Peking Union Medical College, Beijing, China
| | - Haiping Shen
- Department of Maternal and Child Health, National Health and Family Planning Commission of the PRC, Beijing, China
| | - Yiping Zhang
- Department of Maternal and Child Health, National Health and Family Planning Commission of the PRC, Beijing, China
| | - Donghai Yan
- Department of Maternal and Child Health, National Health and Family Planning Commission of the PRC, Beijing, China
| | - Man Zhang
- Center for Clinical Laboratory, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
| | - Yuan He
- National Research Institute for Family Planning, Beijing, China
- National Human Genetic Resources Center, Beijing, China
| | - Zuoqi Peng
- National Research Institute for Family Planning, Beijing, China
- National Human Genetic Resources Center, Beijing, China
| | - Yuanyuan Wang
- National Research Institute for Family Planning, Beijing, China
- National Human Genetic Resources Center, Beijing, China
| | - Jihong Xu
- National Research Institute for Family Planning, Beijing, China
- National Human Genetic Resources Center, Beijing, China
| | - Jun Zhao
- National Research Institute for Family Planning, Beijing, China
- National Human Genetic Resources Center, Beijing, China
| | - Ya Zhang
- National Research Institute for Family Planning, Beijing, China
- National Human Genetic Resources Center, Beijing, China
| | - Hongguang Zhang
- National Research Institute for Family Planning, Beijing, China
- National Human Genetic Resources Center, Beijing, China
| | - Xiaona Xin
- National Research Institute for Family Planning, Beijing, China
- Graduate School of Peking Union Medical College, Beijing, China
| | - Yan Wang
- National Research Institute for Family Planning, Beijing, China
- National Human Genetic Resources Center, Beijing, China
| | - Dujia Liu
- National Research Institute for Family Planning, Beijing, China
- Graduate School of Peking Union Medical College, Beijing, China
| | - Tongjun Guo
- National Research Institute for Family Planning, Beijing, China
- Graduate School of Peking Union Medical College, Beijing, China
| | - Qiaoyun Dai
- National Research Institute for Family Planning, Beijing, China
- National Human Genetic Resources Center, Beijing, China
| | - Xu Ma
- National Research Institute for Family Planning, Beijing, China
- National Human Genetic Resources Center, Beijing, China
- Graduate School of Peking Union Medical College, Beijing, China
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14
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Huntington-Moskos L, Rayens MK, Wiggins A, Hahn EJ. Radon, Secondhand Smoke, and Children in the Home: Creating a Teachable Moment for Lung Cancer Prevention. Public Health Nurs 2016; 33:529-538. [PMID: 27443982 DOI: 10.1111/phn.12283] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE This study determined whether having minor children in the home was associated with the teachable moment (TM) constructs of lung cancer worry, perceived risk, health-related self-concept, and the novel construct of synergistic risk. DESIGN AND SAMPLE Secondary data analysis of baseline data from a randomized controlled trial of an intervention to reduce home exposure to radon and secondhand smoke (SHS). Quota sample of adults recruited at a Central Kentucky academic medical center (N = 556). MEASURES Survey items assessed lung cancer worry, perceived risk, synergistic risk perception, and health-related self-concept. RESULTS The presence of children in the home was not a significant predictor of any construct needed to create a TM for lung cancer prevention. Individuals with children living in the home were more likely to be younger, a racial/ethnic minority, a current smoker, and live with a smoker compared to those without children in the home. CONCLUSIONS There is a critical need to raise parental awareness on child health inequities related to the home exposure to radon and SHS. Public health nurses can create TMs for lung cancer prevention through greater awareness of the risks posed by radon and SHS along with promoting home testing and low-cost resources to reduce risk.
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Affiliation(s)
| | - Mary Kay Rayens
- BREATHE, University of Kentucky (UK), College of Nursing, Lexington, Kentucky
| | - Amanda Wiggins
- BREATHE, University of Kentucky (UK), College of Nursing, Lexington, Kentucky
| | - Ellen J Hahn
- BREATHE, University of Kentucky (UK), College of Nursing, Lexington, Kentucky
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15
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Alomari MA, Al-Sheyab NA. Cigarette smoking lowers blood pressure in adolescents: the Irbid-TRY. Inhal Toxicol 2016; 28:140-4. [DOI: 10.3109/08958378.2016.1145769] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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