The Association Between Tobacco Exposure And Hypertension Among Adult Residents In Ma’anshan City

Objective Tobacco exposure is an important risk factor for cardiovascular disease.This crosssectional study investigated the current situation of adult residents in Ma’anshan City to understand the local tobacco exposure and hypertension and explore the relationship between them,so as to provide a theoretical basis for the development of effective tobacco control measures and hypertension prevention and treatment strategies.Methods From June to November 2020,adult residents in Huashan District,Bowang District and He County of Ma’anshan City were selected for our investigation according to strict inclusion and exclusion criteria.The survey mainly includes two parts:questionnaire survey and physical measurement.The questionnaire included personal basic demographic information,daily life and behavior patterns,hypertension and family history,etc.Individuals’ tobacco exposure was inquired by questionnaire,including current and former smokers’ smoking types,first and regular smoking ages,daily smoking dose,number of years of smoking,and passive smoking status;Physical measurements include height,weight and blood pressure.Unconditioned logistic regression was used to analyze possible risk factors for hypertension,population attributable risk analysis and restricted cubic spline function were used to further explore the relationship between tobacco exposure and hypertension and blood pressure values.Results A total of 14,275 people were investigated in our research,including 13914 qualified samples,with a qualified rate of 97.5%.There were 6,009 males and 7,905 females,and the male to female ratio was 1:1.3.The subjects ranged in age from 18 to 93 years old,with a median age of 65 years old.Among them,those aged 18～ years old,45～years old and ≥ 60 years old accounted for 4.4%,39.9% and 55.7% of the total population,respectively.A total of 3,022 were current smokers,the present smoking rate of 21.7%;There were 6930 passive smokers,with a passive smoking rate of49.8%.Among the smokers,smoking dose≥20 cigarettes/day,smoking years≥20years and smoking index≥30 pack-years were the main.In this study,a total of 6722 patients with hypertension had a crude prevalence of48.3%(standardized rate of 41.4%).Univariate analysis showed that there were significant differences in the prevalence of hypertension among adult residents of Ma’anshan with different gender,age groups,nationalities,education levels,marital status,jobs,gross annual household income,family history of hypertension,BMI,smoking status,frequency of drinking alcohol,frequency of drinking tea,physical exercise and sleep duration.Meaningful variables in the uni-variate analysis analysis were selected for multi-variate analysis,and the multi-variate analysis showed that women had a lower risk of hypertension than men(OR=0.80,95%CI: 0.71～0.89).Compared with the 18～ years old,the ≥ 60 years old had a higher risk of hypertension(OR=1.97,95%CI: 1.60～2.43).Low education,widow,low income,and high BMI all increase the risk of hypertension.Current and former smokers had 0.16 and 0.28 times higher risk of hypertension than never smokers,respectively(OR=1.16,95%CI: 1.02～1.30;OR=1.28,95%CI: 1.09～1.50).Having no family history of hypertension,abstaining from alcohol and getting enough sleep were negatively associated with high blood pressure.The results of the attributable risk analysis indicated that the proportion of hypertension attributable to passive smoking was higher in women than in men,while the proportion attributable to current smoking was reversed(that is to say caused less hypertension than in men).Logistic regression and RCS dose-response graph showed that when the relationship between tobacco exposure and hypertension was analyzed by smoking-related variables(namely smoking dose,smoking years and smoking index),the risk of hypertension also increased with the increase of smoking dose,smoking years and smoking index.The relationship between smoking status and blood pressure(SBP and DBP)under different smoking-related variables showed that SBP and DBP increased with the increase of smoking dose,years and index,except that there did not exist obvious correlation between smoking years and DBP.Conclusion Tobacco exposure and hypertension prevalence of adult residents in Ma’anshan City are not optimistic.Tobacco exposure is an important risk factor for suffering from hypertension,which increases the risk rate of hypertension in the whole people,especially among male smokers and female passive smokers.Never smokers have lower risk of hypertension than current smokers and ex-smokers.The risk of hypertension and blood pressure(SBP and DBP)will increase with the increase of smoking dose,smoking years and smoking index.