Passive Smoking Exposure, Hypertension Risk
A recent study1 revealed that passive smoking exposure is associated with an increased risk of hypertension among non-smoking adults.
The researchers utilized the 2015-2016 National Health and Nutrition Examination Survey (NHANES) to examine this association in 3067 adults in the United States. The results indicated that not only were the odds of hypertension higher due to passive smoking exposure, but men and younger adults were at a higher risk.
Consultant360 reached out to study author Onoja Akpa, PhD, to discuss these findings and their implications. Dr Akpa is a lecturer for the Department of Epidemiology and Medical Statistics at the University of Ibadan College of Medicine in Nigeria.
Consultant360: Passive smoking exposure is a known risk factor for many health problems, including cardiovascular disease (CVD). What prompted you and your research team to examine the association of passive smoking exposure and hypertension?
Onoja Akpa: Tobacco smoking is a critical risk factor for CVD events and several efforts are mobilized to promote smoking bans, particularly in public spaces. However, whether these measures are sufficient to prevent the tobacco smoke consequences among the non-smoking population is yet to be clearly understood.
To that effect, we felt it was necessary to test the association between passive smoking exposure and hypertension—a prime risk factor for CVD events. Also, it is not clear if passive smoking exposure can cause pathological variations to promote elevated blood pressure; this we hope to investigate when funding is available.
C360: Your study defined passive smoking exposure as having been exposed to smoke arising from any form of cigarette in any indoor area, such as the household, restaurant, bar, or car. Did duration or frequency of passive smoking exposure influence your results? What other risk factors did you consider in your analysis?
OA: Duration or frequency of passive smoking exposure was not captured in the NHANES database used for this study. We admit that it would have been interesting to see how this would have impacted our findings. However, we attempted to test the magnitude of exposure duration by comparing hypertension risk among “those without passive smoking exposure only (as reference),” “those with passive smoking exposure only,” “those without passive smoking exposure but use tobacco only,” and “those with passive smoking exposure and also use tobacco only.” We found that passive smoking exposure was associated with hypertension risk in a dose-dependent manner.
Other risk factors we considered included age, race, employment, income, marital status, alcohol use, and body mass index. All these factors were included in the final logistic regression model of the passive smoking exposure–hypertension.
C360: Your results indicated that the prevalence of passive smoking exposure was significantly higher in young adults than in older adults, as well as being higher among men than women. What is the importance of these findings?
OA: These findings suggest disparities in the burden of passive smoking exposure across the spectrum of age and sex. They confirm that men and younger adults are more exposed to passive smoking exposure. Hence, although a population-wide intervention for passive smoking exposure has great benefits, in the case of limited resources and time, interventions may be directed at younger adults and men.
C360: Your study also revealed that passive smoking exposure was significantly associated with hypertension status of patients. How will this finding impact clinical practice?
OA: The study has provided data necessary to reorient the landscape of clinical practice particularly in probing for underlying cause of hypertension in patients. It implies that patients should be required to supply information not only on smoking status but also passive smoking exposures. This information can guide public health advisory for health promotion and suitable blood pressure control management in the population.
Reference:
- Akpa OM, Okekunle AP, Asowata JO, Adedokun B. Passive smoking exposure and the risk of hypertension among non-smoking adults: the 2015-2016 NHANES data. Clin Hypertens. 2021;27(1). doi:10.1186/s40885-020-00159-7