title: Association of passive smoking with masked hypertension in clinically normotensive nonsmokers.
abstract: BACKGROUND
  We investigated ambulatory blood pressure (BP) levels among clinically normotensive nonsmokers exposed (PS) and not exposed (SF) to passive smoking aiming to evaluate the relative prevalence of masked hypertension (MH).
  
  
  METHODS
  From 790 consecutive never-treated subjects who were self-referred to an outpatient hypertensive clinic, we excluded active smokers and those having a mean clinic BP >140/90 mm Hg. In the remaining population, echocardiography and routine biochemical profile assessment was performed, whereas by the implementation of additional exclusion criteria, all clinically normotensive subjects eligible to participate (i.e., 154 PS and 100 SF) underwent to ambulatory BP monitoring.
  
  
  RESULTS
  PS with respect to SF subjects were younger, followed a less hygienic diet and consumed more alcohol (all P < 0.05). Moreover, PS in comparison with SF showed higher 24-h systolic BP, standing diastolic BP, and clinic heart rate (126 +/- 6 mm Hg vs. 122 +/- 5 mm Hg, 89 +/- 4 mm Hg vs. 84 +/- 4 mm Hg and 79 +/- 5 beats/min vs. 73 +/- 4 beats/min, respectively, P < 0.05 for all) and higher prevalence of MH (23% vs. 8%, P < 0.01). After adjustment for confounders determinants of MH remained passive smoking, weekly duration and intensity of passive smoke exposure, younger age, clinic heart rate, low physical activity score, and standing/sitting difference of diastolic BP and heart rate (P < 0.05 for all).
  
  
  CONCLUSIONS
  MH is associated with passive smoking in a dose-related manner and low physical activity, increased heart rate and postural hemodynamic reaction may represent potential accelerators of that phenomenon.
authors.affiliation: Department of Cardiology, Elena Venizelou Hospital, Athens, Greece.
authors.forename: Thomas K
authors.initials: TK
authors.lastname: Makris
authors.forename: Costas
authors.initials: C
authors.lastname: Thomopoulos
authors.forename: Dimitris P
authors.initials: DP
authors.lastname: Papadopoulos
authors.forename: Athanassios
authors.initials: A
authors.lastname: Bratsas
authors.forename: Ourania
authors.initials: O
authors.lastname: Papazachou
authors.forename: Spiros
authors.initials: S
authors.lastname: Massias
authors.forename: Elena
authors.initials: E
authors.lastname: Michalopoulou
authors.forename: Costas
authors.initials: C
authors.lastname: Tsioufis
authors.forename: Christodoulos
authors.initials: C
authors.lastname: Stefanadis
mesh_terms: D000367:Age Factors; D000368:Aged; D000428:Alcohol Drinking / Q000453:epidemiology; D001786:Blood Glucose / Q000378:metabolism; D001794:Blood Pressure / Q000502:physiology; D003404:Creatinine / Q000097:blood; D003430:Cross-Sectional Studies; D004305:Dose-Response Relationship, Drug; D004452:Echocardiography; D005260:Female; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D006973:Hypertension / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology*; D008055:Lipids / Q000097:blood; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D018570:Risk Assessment; D014028:Tobacco Smoke Pollution / Q000009:adverse effects*
chemical_list: D001786:Blood Glucose; D008055:Lipids; D014028:Tobacco Smoke Pollution; D003404:Creatinine