Tobacco smoking strengthens the association of elevated blood pressure with arterial stiffness: the Bogalusa Heart Study.
OBJECTIVE
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.


BACKGROUND
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.


CONCLUSIONS
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.
aDepartment of Epidemiology, Tulane University, New Orleans, Louisiana, USA bCollege of Life and Environment Sciences, Minzu University cDepartment of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China dDepartment of Global Health Systems and Development, Tulane University, New Orleans, Louisiana, USA eDepartment of Cardiology, Peking Union Medical College Hospital, Beijing, China.
Miaoying
M
Yun
Shengxu
S
Li
Dianjianyi
D
Sun
Shaoqing
S
Ge
Chin-Chih
CC
Lai
Camilo
C
Fernandez
Wei
W
Chen
Sathanur R
SR
Srinivasan
Gerald S
GS
Berenson
D000293:Adolescent; D000328:Adult; D001011:Aorta / Q000503:physiopathology; D019540:Area Under Curve; D001158:Arteries / Q000502:physiology; D044383:Black People; D001794:Blood Pressure; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D006339:Heart Rate; D006801:Humans; D006973:Hypertension / Q000503:physiopathology; D008145:Louisiana / Q000453:epidemiology; D008297:Male; D063177:Pulse Wave Analysis; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects*; D059289:Vascular Stiffness; D044465:White People; D055815:Young Adult; D001741:Black or African American