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BMC Public Health
Published in: BMC Public Health 1/2021

Open Access 01-12-2021 | Research article

Relationship between the duration of smoking and blood pressure in Han and ethnic minority populations: a cross-sectional study in China

Authors: Yuelun Zhang, Yunying Feng, Shi Chen, Siyu Liang, Shirui Wang, Ke Xu, Dongping Ning, Xianxian Yuan, Huijuan Zhu, Hui Pan, Guangliang Shan

Published in: BMC Public Health | Issue 1/2021

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Abstract

Background

Evidence for correlation between the cigarette use and blood pressure change remains ambiguous. This study modelled relationship between the duration of smoking and systolic blood pressure in a large national multi-ethnic cross-sectional survey in China.

Methods

Participants were selected through a multi-stage probability sampling procedure from 2012 to 2017. Former or current smokers were included in this study, whose smoking behaviour, blood pressure, and other demographic information were collected and measured through a face-to-face interview. Linear and non-linear relationships between the duration of smoking and systolic blood pressure were analysed and differences of the association between Han and minority populations were specially checked.

Results

A total of 8801 participants were enrolled in this study. Prevalence of hypertension was 41.3 and 77.8% were current smokers. For every additional year of smoking duration, systolic blood pressure raised by 0.325 mmHg (95% CI 0.296 to 0.354 mmHg, P <  0.001). The Chinese minority populations may suffer more from the elevated blood pressure in long-term smoking than Han populations (0.283 mmHg (95% CI 0.252 to 0.314 mmHg, P <  0.001) versus 0.450 mmHg (95% CI 0.380 to 0.520 mmHg, P <  0.001) raise in systolic blood pressure with each additional year of smoking in minority and Han populations).

Conclusions

Smoking is associated with raised systolic blood pressure in Chinese population. This association is notedly stronger in Chinese minority populations.
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Literature
1.
2.
3.
Dikalov S, Itani H, Richmond B, Arslanbaeva L, Vergeade A, Rahman SJ, Boutaud O, Blackwell T, Massion PP, Harrison DG. Tobacco smoking induces cardiovascular mitochondrial oxidative stress, promotes endothelial dysfunction, and enhances hypertension. Am J Phys Heart Circ Phys. 2019;316(3):H639–46.
4.
Talukder MH, Johnson WM, Varadharaj S, Lian J, Kearns PN, El-Mahdy MA, Liu X, Zweier JL. Chronic cigarette smoking causes hypertension, increased oxidative stress, impaired NO bioavailability, endothelial dysfunction, and cardiac remodeling in mice. Am J Phys Heart Circ Phys. 2011;300(1):H388–96.
5.
Lee D-H, Ha M-H, Kim J-R, Jacobs DR Jr. Effects of smoking cessation on changes in blood pressure and incidence of hypertension: a 4-year follow-up study. Hypertension. 2001;37(2):194–8.CrossRef
6.
Thuy AB, Blizzard L, Schmidt MD, Luc PH, Granger RH, Dwyer T. The association between smoking and hypertension in a population-based sample of Vietnamese men. J Hypertens. 2010;28(2):245–50.CrossRef
7.
Niskanen L, Laaksonen DE, Nyyssönen K, Punnonen K, Valkonen V-P, Fuentes R, Tuomainen T-P, Salonen R, Salonen JT. Inflammation, abdominal obesity, and smoking as predictors of hypertension. Hypertension. 2004;44(6):859–65.CrossRef
8.
Bowman TS, Gaziano JM, Buring JE, Sesso HD. A prospective study of cigarette smoking and risk of incident hypertension in women. J Am Coll Cardiol. 2007;50(21):2085–92.CrossRef
9.
Hu W, Zhang T, Shi J, Qin W, Tong L, Shen Y. Association between cigarette smoking and hypertension in men: a dose response relationship analysis. Chin J Cardiol. 2014;42(9):773.
10.
Green MS, Jucha E, Luz Y. Blood pressure in smokers and nonsmokers: epidemiologic findings. Am Heart J. 1986;111(5):932–40.CrossRef
11.
Gu H, Li W, Yang J, Wang Y, Bo J, Liu L. Hypertension prevalence, awareness, treatment and control among Han and four ethnic minorities (Uygur, Hui, Mongolian and Dai) in China. J Hum Hypertens. 2015;29(9):555–60.CrossRef
12.
Giles T, Aranda JM Jr, Suh DC, Choi IS, Preblick R, Rocha R, Frech-Tamas F. Ethnic/racial variations in blood pressure awareness, treatment, and control. J Clin Hypertens. 2007;9(5):345–54.CrossRef
13.
Dong F, Wang D, Pan L, Yu Y, Wang K, Li L, Wang L, Liu T, Zeng X, Sun L. Disparities in hypertension prevalence, awareness, treatment and control between Bouyei and Han: results from a bi-ethnic health survey in developing regions from South China. Int J Environ Res Public Health. 2016;13(2):233.CrossRef
14.
Cai L, Wang X-M, Fan L-M, Cui W-L, Golden AR. Socioeconomic disparities in prevalence and behaviors of smoking in rural Southwest China. BMC Public Health. 2019;19(1):1117.CrossRef
15.
Von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP. The strengthening the reporting of observational studies in epidemiology (STROBE) statement: guidelines for reporting observational studies. Ann Intern Med. 2007;147(8):573–7.CrossRef
16.
Pan L, Dong F, Wang K, Wang L, Gong H, Xu G, Shan G. Towards better clinical laboratory diagnostic criteria for haemoglobin concentration: results from the survey on health examination and physiological constants in China. Lancet. 2015;386:S59.CrossRef
17.
He H, Pan L, Pa L, Cui Z, Ren X, Wang D, Liu F, Wang X, Du J, Wang H. Data resource profile: the china national health survey (CNHS). In J Epidemiol. 2018;47(6):1734–1735f.
18.
Alberti KGMM, Zimmet PZ. Definition, diagnosis and classification of diabetes mellitus and its complications. Part 1: diagnosis and classification of diabetes mellitus. Provisional report of a WHO consultation. Diabet Med. 1998;15(7):539–53.CrossRef
19.
Muggeo VM. Interval estimation for the breakpoint in segmented regression: a smoothed score-based approach. Aust N Z J Stat. 2017;59(3):311–22.CrossRef
20.
Altman DG, Bland JM. Interaction revisited: the difference between two estimates. BMJ. 2003;326(7382):219.CrossRef
21.
22.
23.
24.
25.
Greenland P, Knoll MD, Stamler J, Neaton JD, Dyer AR, Garside DB, Wilson PW. Major risk factors as antecedents of fatal and nonfatal coronary heart disease events. JAMA. 2003;290(7):891–7.CrossRef
26.
Narkiewicz K, Kjeldsen SE, Hedner T. Is smoking a causative factor of hypertension? Blood Press. 2005;14(2):69–71.
27.
Linneberg A, Jacobsen RK, Skaaby T, Taylor AE, Fluharty ME, Jeppesen JL, Bjorngaard JH, Åsvold BO, Gabrielsen ME, Campbell A. Effect of smoking on blood pressure and resting heart rate: a Mendelian randomization meta-analysis in the CARTA consortium. Circ Cardiovasc Genet. 2015;8(6):832–41.CrossRef
28.
Dochi M, Sakata K, Oishi M, Tanaka K, Kobayashi E, Suwazono Y. Smoking as an independent risk factor for hypertension: a 14-year longitudinal study in male Japanese workers. Tohoku J Exp Med. 2009;217(1):37–43.CrossRef
29.
Li H, Tong W, Wang A, Lin Z, Zhang Y. Effects of cigarette smoking on blood pressure stratified by BMI in Mongolian population, China. Blood Press. 2010;19(2):92–7.CrossRef
30.
Freathy RM, Kazeem GR, Morris RW, Johnson PC, Paternoster L, Ebrahim S, Hattersley AT, Hill A, Hingorani AD, Holst C. Genetic variation at CHRNA5-CHRNA3-CHRNB4 interacts with smoking status to influence body mass index. Int J Epidemiol. 2011;40(6):1617–28.CrossRef
31.
Timpson NJ, Harbord R, Davey Smith G, Zacho J, Tybjærg-Hansen A, Nordestgaard BG. Does greater adiposity increase blood pressure and hypertension risk? Mendelian randomization using the FTO/MC4R genotype. Hypertension. 2009;54(1):84–90.CrossRef
32.
Seven E, Husemoen LL, Wachtell K, Ibsen H, Linneberg A, Jeppesen JL. Five-year weight changes associate with blood pressure alterations independent of changes in serum insulin. J Hypertens. 2014;32(11):2231–7.CrossRef
33.
Middlekauff HR, Park J, Moheimani RS. Adverse effects of cigarette and noncigarette smoke exposure on the autonomic nervous system: mechanisms and implications for cardiovascular risk. J Am Coll Cardiol. 2014;64(16):1740–50.CrossRef
34.
Ambrose JA, Barua RS. The pathophysiology of cigarette smoking and cardiovascular disease: an update. J Am Coll Cardiol. 2004;43(10):1731–7.CrossRef
35.
Abboud F. Effects of sodium, angiotensin, and steroids on vascular reactivity in man. Fed Proc. 1974;1974:143.
36.
Wang H, Yu M, Ochani M, Amella CA, Tanovic M, Susarla S, Li JH, Wang H, Yang H, Ulloa L. Nicotinic acetylcholine receptor α7 subunit is an essential regulator of inflammation. Nature. 2003;421(6921):384–8.CrossRef
37.
Wang Y, Zhang F, Yang W, Xue S. Nicotine induces pro-inflammatory response in aortic vascular smooth muscle cells through a NFκB/osteopontin amplification loop-dependent pathway. Inflammation. 2012;35(1):342–9.CrossRef
38.
Khan JM, Beevers DG. Management of hypertension in ethnic minorities. Heart. 2005;91(8):1105–9.CrossRef
39.
Jones DW, Hall JE. Racial and ethnic differences in blood pressure: biology and sociology. Circulation. 2006;114(25):2757–9.CrossRef
40.
Li G, Guo G, Wang W, Wang K, Wang H, Dong F, Qian Y, Gong H, Xu G, Li Y. Association of prehypertension and cardiovascular risk factor clustering in Inner Mongolia: a cross-sectional study. BMJ Open. 2017;7(6):e015340.
41.
Tu W, Eckert GJ, Hannon TS, Liu H, Pratt LM, Wagner MA, DiMeglio LA, Jung J, Pratt JH. Racial differences in sensitivity of blood pressure to aldosterone. Hypertension. 2014;63(6):1212–8.CrossRef
42.
Ferdinand KC, Nasser SA. Understanding the importance of race/ethnicity in the care of the hypertensive patient. Curr Hypertens Rep. 2015;17(3):15.CrossRef
Metadata
Title
Relationship between the duration of smoking and blood pressure in Han and ethnic minority populations: a cross-sectional study in China
Authors
Yuelun Zhang
Yunying Feng
Shi Chen
Siyu Liang
Shirui Wang
Ke Xu
Dongping Ning
Xianxian Yuan
Huijuan Zhu
Hui Pan
Guangliang Shan
Publication date
01-12-2021
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2021
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-020-09975-w

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