1
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Kaplan RC, Baldoni PL, Strizich GM, Pérez-Stable EJ, Saccone NL, Peralta CA, Perreira KM, Gellman MD, Williams-Nguyen JS, Rodriguez CJ, Lee DJ, Daviglus M, Talavera GA, Lash JP, Cai J, Franceschini N. Current Smoking Raises Risk of Incident Hypertension: Hispanic Community Health Study-Study of Latinos. Am J Hypertens 2021; 34:190-197. [PMID: 32968788 DOI: 10.1093/ajh/hpaa152] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 08/28/2020] [Accepted: 09/22/2020] [Indexed: 12/15/2022] Open
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.
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Affiliation(s)
- Robert C Kaplan
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, USA
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - Pedro L Baldoni
- Department of Biostatistics, University of North Carolina-Chapel Hill, Chapel Hill, North Carolina, USA
| | - Garrett M Strizich
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Eliseo J Pérez-Stable
- National Institute on Minority Health and Health Disparities, Bethesda, Maryland, USA
| | - Nancy L Saccone
- Division of Biology and Biomedical Sciences, Washington University, St. Louis, Missouri, USA
| | - Carmen A Peralta
- Department of Medicine, University of California-San Francisco, San Francisco, California, USA
| | - Krista M Perreira
- Department of Social Medicine, University of North Carolina-Chapel Hill, Chapel Hill, North Carolina, USA
| | - Marc D Gellman
- Department of Psychology, University of Miami, Miami, Florida, USA
| | | | - Carlos J Rodriguez
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, USA
| | - David J Lee
- Department of Public Health Sciences, University of Miami, Coral Gables, Florida, USA
| | - Martha Daviglus
- Department of Medicine, University of Illinois-Chicago, Chicago, Illinois, USA
| | - Gregory A Talavera
- School of Public Health, San Diego State University, San Diego, California, USA
| | - James P Lash
- Department of Medicine, University of Illinois-Chicago, Chicago, Illinois, USA
| | - Jianwen Cai
- Department of Biostatistics, University of North Carolina-Chapel Hill, Chapel Hill, North Carolina, USA
| | - Nora Franceschini
- Department of Epidemiology, University of North Carolina-Chapel Hill, Chapel Hill, North Carolina, USA
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2
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Andriolo V, Dietrich S, Knüppel S, Bernigau W, Boeing H. Traditional risk factors for essential hypertension: analysis of their specific combinations in the EPIC-Potsdam cohort. Sci Rep 2019; 9:1501. [PMID: 30728434 PMCID: PMC6365562 DOI: 10.1038/s41598-019-38783-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Accepted: 01/03/2019] [Indexed: 11/30/2022] Open
Abstract
Appropriate interventions might improve the prevention of essential hypertension. This requires a comprehensive view of modifiable lifestyle factors (MLFs) distribution and effect. To determine how six MLFs (general adiposity, abdominal adiposity, alcohol consumption, smoking, diet, physical inactivity) for risk of hypertension are distributed and how their combinations affect the risk, a prospective study cohort of 11,923 healthy participants from the population-based European Prospective Investigation into Cancer and Nutrition (EPIC)-Potsdam Study was used. Of these, 1,635 developed hypertension during a mean follow-up of 10.3 years. Mutually exclusive combinations, clustering and interactions of MLFs were then investigated stratifying by sex, Hazard Ratios (HRs) and Population Attributable Risks (PARs%) were calculated. General adiposity alone was sufficient to increase the risk of hypertension (HR = 1.86, PAR% 3.36), and in this cohort it played a major role in enhancing the risk of hypertension, together with smoking and physical inactivity. MLFs had a different impact and a different modulation of risk in women and men, and they showed a remarkable tendency to occur in specific patterns with higher prevalence than expected. This indication can help to promote a holistic approach through multifactorial preventive strategies addressing more than a factor at a time. For prevention of hypertension addressing adiposity together with smoking, promoting at the same time physical activity should be the first choice.
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Affiliation(s)
- Violetta Andriolo
- Department of Epidemiology, German Institute of Human Nutrition, Potsdam-Rehbrücke (DIfE), Germany.
| | - Stefan Dietrich
- Department of Molecular Epidemiology, German Institute of Human Nutrition, Potsdam-Rehbrücke (DIfE), Germany
| | - Sven Knüppel
- Department of Epidemiology, German Institute of Human Nutrition, Potsdam-Rehbrücke (DIfE), Germany
| | - Wolfgang Bernigau
- Department of Epidemiology, German Institute of Human Nutrition, Potsdam-Rehbrücke (DIfE), Germany
| | - Heiner Boeing
- Department of Epidemiology, German Institute of Human Nutrition, Potsdam-Rehbrücke (DIfE), Germany
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3
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Affiliation(s)
- Toshiaki Ebina
- Department of Laboratory Medicine and Clinical Investigation/Division of Cardiology, Yokohama City University Medical Center
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4
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Bermudez V, Olivar LC, Torres W, Navarro C, Gonzalez R, Espinoza C, Morocho A, Mindiola A, Chacin M, Arias V, Añez R, Salazar J, Riaño-Garzon M, Diaz-Camargo E, Bautista MJ, Rojas J. Cigarette smoking and metabolic syndrome components: a cross-sectional study from Maracaibo City, Venezuela. F1000Res 2018; 7:565. [PMID: 30705749 PMCID: PMC6343224 DOI: 10.12688/f1000research.14571.2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/18/2018] [Indexed: 10/06/2023] Open
Abstract
Background: A growing body of evidence suggests that cigarette smoking can cause the onset of metabolic syndrome prior to cardiovascular diseases. Therefore, the objective of this study was to evaluate the relationship between smoking habit and metabolic syndrome components in an adult population from Maracaibo city, Venezuela. Methods: The Maracaibo City Metabolic Syndrome Prevalence Study is a descriptive, cross-sectional study with random and multi-stage sampling. In this sub-study, 2212 adults from both genders were selected. On the basis of their medical background, they were classified as smokers, non-smokers and former smokers. Metabolic syndrome was defined according to Harmonizing 2009 criteria, using population-specific abdominal circumference cut-off points. The association between risk factors was evaluated using a logistic regression model. Results: In the studied population, 14.8% were smokers, 15.4% were former smokers. In the multivariate analysis, the presence of metabolic syndrome (smokers: OR, 1.54; 95% CI, 1.11-2.14; p=0.010) and its components were related to cigarette smoking, with the exception of hyperglycemia. High blood pressure was inversely associated with current smoking status (smokers: OR, 0.70 (0.51-0.95); p=0.025). Conclusion: Cigarette smoking represents a related factor with metabolic syndrome, being associated with low high-density lipoprotein-cholesterol, increased abdominal circumference and elevated triacylglyceride levels. Former smokers did not present a greater risk for developing this metabolic disease when compared to non-smokers. The effect of avoiding this habit should be evaluated in future studies in our population.
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Affiliation(s)
- Valmore Bermudez
- Grupo de Investigación Altos Estudios de Frontera, Universidad Simón Bolívar, Cúcuta, Colombia
- Endocrine and Metabolic Diseases Research Center, School of Medicine, University of Zulia, Maracaibo, Venezuela
| | - Luis Carlos Olivar
- Endocrine and Metabolic Diseases Research Center, School of Medicine, University of Zulia, Maracaibo, Venezuela
| | - Wheeler Torres
- Endocrine and Metabolic Diseases Research Center, School of Medicine, University of Zulia, Maracaibo, Venezuela
| | - Carla Navarro
- Endocrine and Metabolic Diseases Research Center, School of Medicine, University of Zulia, Maracaibo, Venezuela
| | - Robys Gonzalez
- Endocrine and Metabolic Diseases Research Center, School of Medicine, University of Zulia, Maracaibo, Venezuela
| | - Cristobal Espinoza
- Latacunga Province General Hospital, Ministry of Public Health, Cotopaxi, Ecuador
| | - Alicia Morocho
- Latacunga Province General Hospital, Ministry of Public Health, Cotopaxi, Ecuador
| | - Andres Mindiola
- Geriatric Research Education and Clinical Center, United States Department of Veterans Affairs, Miami, Florida, USA
| | - Maricarmen Chacin
- Endocrine and Metabolic Diseases Research Center, School of Medicine, University of Zulia, Maracaibo, Venezuela
| | - Victor Arias
- Grupo de Investigación Altos Estudios de Frontera, Universidad Simón Bolívar, Cúcuta, Colombia
| | - Roberto Añez
- Endocrine and Metabolic Diseases Research Center, School of Medicine, University of Zulia, Maracaibo, Venezuela
| | - Juan Salazar
- Endocrine and Metabolic Diseases Research Center, School of Medicine, University of Zulia, Maracaibo, Venezuela
| | - Manuel Riaño-Garzon
- Grupo de Investigación Altos Estudios de Frontera, Universidad Simón Bolívar, Cúcuta, Colombia
| | - Edgar Diaz-Camargo
- Grupo de Investigación Altos Estudios de Frontera, Universidad Simón Bolívar, Cúcuta, Colombia
| | - Maria Judith Bautista
- Grupo de Investigación Altos Estudios de Frontera, Universidad Simón Bolívar, Cúcuta, Colombia
| | - Joselyn Rojas
- Endocrine and Metabolic Diseases Research Center, School of Medicine, University of Zulia, Maracaibo, Venezuela
- Division of Pulmonary and Critical Care Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts, 02115, USA
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5
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Bermudez V, Olivar LC, Torres W, Navarro C, Gonzalez R, Espinoza C, Morocho A, Mindiola A, Chacin M, Arias V, Añez R, Salazar J, Riaño-Garzon M, Diaz-Camargo E, Bautista MJ, Rojas J. Cigarette smoking and metabolic syndrome components: a cross-sectional study from Maracaibo City, Venezuela. F1000Res 2018; 7:565. [PMID: 30705749 PMCID: PMC6343224 DOI: 10.12688/f1000research.14571.3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/09/2019] [Indexed: 12/24/2022] Open
Abstract
Background: A growing body of evidence suggests that cigarette smoking can cause the onset of metabolic syndrome prior to cardiovascular diseases. Therefore, the objective of this study was to evaluate the relationship between smoking habit and metabolic syndrome components in an adult population from Maracaibo city, Venezuela. Methods: The Maracaibo City Metabolic Syndrome Prevalence Study is a descriptive, cross-sectional study with random and multi-stage sampling. In this sub-study, 2212 adults from both genders were selected. On the basis of their medical background, they were classified as smokers, non-smokers and former smokers. Metabolic syndrome was defined according to Harmonizing 2009 criteria, using population-specific abdominal circumference cut-off points. The association between risk factors was evaluated using a logistic regression model. Results: In the studied population, 14.8% were smokers, 15.4% were former smokers. In the multivariate analysis, the presence of metabolic syndrome (smokers: OR, 1.54; 95% CI, 1.11-2.14; p=0.010) and its components were related to cigarette smoking, with the exception of hyperglycemia. High blood pressure was inversely associated with current smoking status (smokers: OR, 0.70 (0.51-0.95); p=0.025). Conclusion: Cigarette smoking represents a related factor with metabolic syndrome, being associated with low high-density lipoprotein-cholesterol, increased abdominal circumference and elevated triacylglyceride levels. Former smokers did not present a greater risk for developing this metabolic disease when compared to non-smokers. The effect of avoiding this habit should be evaluated in future studies in our population.
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Affiliation(s)
- Valmore Bermudez
- Grupo de Investigación Altos Estudios de Frontera, Universidad Simón Bolívar, Cúcuta, Colombia
- Endocrine and Metabolic Diseases Research Center, School of Medicine, University of Zulia, Maracaibo, Venezuela
| | - Luis Carlos Olivar
- Endocrine and Metabolic Diseases Research Center, School of Medicine, University of Zulia, Maracaibo, Venezuela
| | - Wheeler Torres
- Endocrine and Metabolic Diseases Research Center, School of Medicine, University of Zulia, Maracaibo, Venezuela
| | - Carla Navarro
- Endocrine and Metabolic Diseases Research Center, School of Medicine, University of Zulia, Maracaibo, Venezuela
| | - Robys Gonzalez
- Endocrine and Metabolic Diseases Research Center, School of Medicine, University of Zulia, Maracaibo, Venezuela
| | - Cristobal Espinoza
- Latacunga Province General Hospital, Ministry of Public Health, Cotopaxi, Ecuador
| | - Alicia Morocho
- Latacunga Province General Hospital, Ministry of Public Health, Cotopaxi, Ecuador
| | - Andres Mindiola
- Geriatric Research Education and Clinical Center, United States Department of Veterans Affairs, Miami, Florida, USA
| | - Maricarmen Chacin
- Endocrine and Metabolic Diseases Research Center, School of Medicine, University of Zulia, Maracaibo, Venezuela
| | - Victor Arias
- Grupo de Investigación Altos Estudios de Frontera, Universidad Simón Bolívar, Cúcuta, Colombia
| | - Roberto Añez
- Endocrine and Metabolic Diseases Research Center, School of Medicine, University of Zulia, Maracaibo, Venezuela
| | - Juan Salazar
- Endocrine and Metabolic Diseases Research Center, School of Medicine, University of Zulia, Maracaibo, Venezuela
| | - Manuel Riaño-Garzon
- Grupo de Investigación Altos Estudios de Frontera, Universidad Simón Bolívar, Cúcuta, Colombia
| | - Edgar Diaz-Camargo
- Grupo de Investigación Altos Estudios de Frontera, Universidad Simón Bolívar, Cúcuta, Colombia
| | - Maria Judith Bautista
- Grupo de Investigación Altos Estudios de Frontera, Universidad Simón Bolívar, Cúcuta, Colombia
| | - Joselyn Rojas
- Endocrine and Metabolic Diseases Research Center, School of Medicine, University of Zulia, Maracaibo, Venezuela
- Division of Pulmonary and Critical Care Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts, 02115, USA
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6
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Bermudez V, Olivar LC, Torres W, Navarro C, Gonzalez R, Espinoza C, Morocho A, Mindiola A, Chacin M, Arias V, Añez R, Salazar J, Riaño-Garzon M, Diaz-Camargo E, Bautista MJ, Rojas J. Cigarette smoking and metabolic syndrome components: a cross-sectional study from Maracaibo City, Venezuela. F1000Res 2018; 7:565. [PMID: 30705749 PMCID: PMC6343224 DOI: 10.12688/f1000research.14571.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/24/2018] [Indexed: 10/06/2023] Open
Abstract
Background: A growing body of evidence suggests that cigarette smoking can cause the onset of metabolic syndrome prior to cardiovascular diseases. Therefore, the objective of this study was to evaluate the relationship between smoking habit and metabolic syndrome components in an adult population from Maracaibo city, Venezuela. Methods: The Maracaibo City Metabolic Syndrome Prevalence Study is a descriptive, cross-sectional study with random and multi-stage sampling. In this sub-study, 2212 adults from both genders were selected. On the basis of their medical background, they were classified as smokers, non-smokers and former smokers. Metabolic syndrome was defined according to Harmonizing 2009 criteria, using population-specific abdominal circumference cut-off points. The association between risk factors was evaluated using a logistic regression model. Results: In the studied population, 14.8% were smokers, 15.4% were former smokers. In the multivariate analysis, the presence of metabolic syndrome (smokers: OR, 1.54; 95% CI, 1.11-2.14; p=0.010) and its components were related to cigarette smoking, with the exception of hyperglycemia. High blood pressure was inversely associated with current smoking status (smokers: OR, 0.70 (0.51-0.95); p=0.025). Conclusion: Cigarette smoking represents an independent risk factor for the development of metabolic syndrome, being associated with low high-density lipoprotein-cholesterol, increased abdominal circumference and elevated triacylglyceride levels. Former smokers did not present a greater risk for developing this metabolic disease when compared to non-smokers. The effect of avoiding this habit should be evaluated in future studies in our population.
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Affiliation(s)
- Valmore Bermudez
- Grupo de Investigación Altos Estudios de Frontera, Universidad Simón Bolívar, Cúcuta, Colombia
- Endocrine and Metabolic Diseases Research Center, School of Medicine, University of Zulia, Maracaibo, Venezuela
| | - Luis Carlos Olivar
- Endocrine and Metabolic Diseases Research Center, School of Medicine, University of Zulia, Maracaibo, Venezuela
| | - Wheeler Torres
- Endocrine and Metabolic Diseases Research Center, School of Medicine, University of Zulia, Maracaibo, Venezuela
| | - Carla Navarro
- Endocrine and Metabolic Diseases Research Center, School of Medicine, University of Zulia, Maracaibo, Venezuela
| | - Robys Gonzalez
- Endocrine and Metabolic Diseases Research Center, School of Medicine, University of Zulia, Maracaibo, Venezuela
| | - Cristobal Espinoza
- Latacunga Province General Hospital, Ministry of Public Health, Cotopaxi, Ecuador
| | - Alicia Morocho
- Latacunga Province General Hospital, Ministry of Public Health, Cotopaxi, Ecuador
| | - Andres Mindiola
- Geriatric Research Education and Clinical Center, United States Department of Veterans Affairs, Miami, Florida, USA
| | - Maricarmen Chacin
- Endocrine and Metabolic Diseases Research Center, School of Medicine, University of Zulia, Maracaibo, Venezuela
| | - Victor Arias
- Grupo de Investigación Altos Estudios de Frontera, Universidad Simón Bolívar, Cúcuta, Colombia
| | - Roberto Añez
- Endocrine and Metabolic Diseases Research Center, School of Medicine, University of Zulia, Maracaibo, Venezuela
| | - Juan Salazar
- Endocrine and Metabolic Diseases Research Center, School of Medicine, University of Zulia, Maracaibo, Venezuela
| | - Manuel Riaño-Garzon
- Grupo de Investigación Altos Estudios de Frontera, Universidad Simón Bolívar, Cúcuta, Colombia
| | - Edgar Diaz-Camargo
- Grupo de Investigación Altos Estudios de Frontera, Universidad Simón Bolívar, Cúcuta, Colombia
| | - Maria Judith Bautista
- Grupo de Investigación Altos Estudios de Frontera, Universidad Simón Bolívar, Cúcuta, Colombia
| | - Joselyn Rojas
- Endocrine and Metabolic Diseases Research Center, School of Medicine, University of Zulia, Maracaibo, Venezuela
- Division of Pulmonary and Critical Care Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts, 02115, USA
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