Effects of smoking intensity trajectory, cumulative smoking exposure, and the number of years since quitting on the subsequent risk of hypertension

Abstract

The aim of this study was to investigate the effects of smoking intensity trajectory, cumulative smoking exposure, and the number of years since quitting on the subsequent risk of hypertension in Chinese adults. The study included 2783 men and 3416 women who participated in at least three waves of the China Health and Nutrition Survey. Information regarding smoking behavior was obtained using a standardized questionnaire. The trajectory of smoking intensity was determined using a group-based trajectory model. The number of pack-years of smoking and the number of years since quitting were calculated. The incidence of hypertension was 18.2% and 15.5% in men and women, respectively, during a median follow-up duration of 4 years. Male participants with trajectories denoting light and moderate smoking had increased risks of hypertension compared with those with trajectories denoting non-smoking (P_s < .05). Compared with male participants with 0 pack-years, those with < 5.5 pack-years had a higher risk of hypertension (P < .05). Male participants with ≥5.5 pack-years and weight gain had a higher risk of hypertension compared with those with 0 pack-years and weight loss (P < .05). However, smoking was not related to an increased risk of hypertension in women. Additionally, similar to never smoking, having quit within 2-5 years or ≥5 years was not associated with the incidence of hypertension in men. The results of this study showed that light/moderate smoking or high cumulative smoking exposure accompanied by weight gain increased the risk of hypertension in Chinese men and smoking cessation decreased this effect.

Keywords: hypertension; smoking; trajectories.