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  • Title: Tobacco smoking strengthens the association of elevated blood pressure with arterial stiffness: the Bogalusa Heart Study.
    Author: Yun M, Li S, Sun D, Ge S, Lai CC, Fernandez C, Chen W, Srinivasan SR, Berenson GS.
    Journal: J Hypertens; 2015 Feb; 33(2):266-74. PubMed ID: 25380147.
    Abstract:
    OBJECTIVES: The study assessed the hypothesis that smoking strengthens the association of adult arterial stiffness with long-term cumulative burden of blood pressure (BP) from childhood to adulthood. BACKGROUNDS: Tobacco smoking and elevated BPs are important risk factors of vascular stiffness. However, the synergistic effect of these two risk factors is not well established, especially for the long-term burden of elevated BP since childhood. METHODS: The study cohort consisted of 945 adults (661 whites and 284 blacks, aged 24-43 years) who have BP measured 4-15 times since childhood (aged 4-17 years) in Bogalusa, Louisiana. The adult arterial stiffness was measured as aorta-femoral pulse wave velocity (afPWV); the total area under the curve (AUC) and incremental AUC were used as a measure of long-term burden and trends of BP, respectively. RESULTS: Increased adult afPWV was significantly associated with higher adulthood (P < 0.001), total AUC (P < 0.001) and incremental AUC (P < 0.001) values of SBP and DBP, but not with childhood BP, after adjusting for age, race, sex, BMI and heart rate. Furthermore, smoking was a significant predictor of increased adult afPWV and BP levels. In the interaction analyses, the increasing trend of afPWV with increasing adult SBP (P = 0.009) and its incremental AUC (P = 0.007) were significantly greater among the current smokers than among the nonsmokers. DBP showed a similar pattern regarding the smoking-BP interaction on afPWV. CONCLUSION: These results, by showing the synergistic effect of tobacco smoking and long-term BP measures from childhood to adulthood on arterial stiffening process, underscore the importance of undertaking preventive strategies early in life and smoking behavior control.
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