Tobacco Smoking and Blood Pressure: How Are They Related Among the Indians? - A Secondary Analysis of National Family Health Survey (NFHS)-4 Data

Overview

Journal J Family Med Prim Care

Specialty Public Health

Date 2022 Dec 12

PMID 36505644

Authors

Barsha Gadapani Pathak

S Rahini

Rukman M Manapurath

B N Sharath

Rakesh Gupta

Sonu Goel

Affiliations

Soon will be listed here.

Abstract

Background: India, the second leading producer of tobacco, puts the population at a higher chance of tobacco consumption contributing to a significant disease burden. Though tobacco smoking is a modifiable risk factor for hypertension and has been on the rise among the population, studies on the relationship of tobacco with hypertension are limited in India.

Aim: This study aimed to assess the population-level risk of tobacco (smoke) use and elevated blood pressure (BP) among Indians and also assess the association of risk of tobacco smoking with hypertension based on the place of residence.

Materials And Methods: Data from the National Family Health Survey (NFHS)-4 conducted between January 2015 and December 2016 was utilized. The prevalence of hypertension and its magnitude of association with smoking factors was found using univariable logistic regression. Multivariable logistic regression was performed to predict the association of smoking products with elevated BP by adjusting the model for sociodemographic factors, illness, physical characteristics, and state-wise data.

Results: The weighted prevalence of hypertension was 16.56% (confidence interval [CI]: 16.34-16.78) in males and 11.20% (CI: 11.12-11.27) in females. Among those who smoked tobacco, 15.3% women and 22.4% men were hypertensive. This study highlights the significant association of smoking of various tobacco products with hypertension in both men and women on univariate analysis. But the adjusted mean elevated BP among the tobacco-using males and females was not significantly associated with smoking cigarettes, pipe, cigars, and hookah.

Conclusion: Cigarette smoking is a modifiable factor for the development and progression of hypertension. Adequate preventive and promotive health measures targeting the young, rural inhabitants and the poorer sections of society may help in reducing tobacco consumption.

Citing Articles

Hypertension care cascade in an urban resettlement colony and slum in Delhi, India: a cross-sectional survey.

Singh M, Basu S, Lalwani H, Rao S, Maheshwari V, Garg S BMC Public Health. 2023; 23(1):2116.

PMID: 37891517 PMC: 10612386. DOI: 10.1186/s12889-023-17021-8.

References

Benowitz N, Burbank A . Cardiovascular toxicity of nicotine: Implications for electronic cigarette use. Trends Cardiovasc Med. 2016; 26(6):515-23. PMC: 4958544. DOI: 10.1016/j.tcm.2016.03.001. View

Levy R, Brathwaite K, Sarathy H, Reidy K, Kaskel F, Melamed M . Analysis of Active and Passive Tobacco Exposures and Blood Pressure in US Children and Adolescents. JAMA Netw Open. 2021; 4(2):e2037936. PMC: 7903259. DOI: 10.1001/jamanetworkopen.2020.37936. View

Natsis M, Antza C, Doundoulakis I, Stabouli S, Kotsis V . Hypertension in Obesity: Novel Insights. Curr Hypertens Rev. 2019; 16(1):30-36. DOI: 10.2174/1573402115666190415154603. View

Salahuddin S, Prabhakaran D, Roy A . Pathophysiological Mechanisms of Tobacco-Related CVD. Glob Heart. 2015; 7(2):113-20. DOI: 10.1016/j.gheart.2012.05.003. View

Saha S, Bhalla D, Whayne Jr T, Gairola C . Cigarette smoke and adverse health effects: An overview of research trends and future needs. Int J Angiol. 2012; 16(3):77-83. PMC: 2733016. DOI: 10.1055/s-0031-1278254. View

Li G, Wang H, Wang K, Wang W, Dong F, Qian Y . The association between smoking and blood pressure in men: a cross-sectional study. BMC Public Health. 2017; 17(1):797. PMC: 5634904. DOI: 10.1186/s12889-017-4802-x. View

Simonds S, Cowley M . Hypertension in obesity: is leptin the culprit?. Trends Neurosci. 2013; 36(2):121-32. DOI: 10.1016/j.tins.2013.01.004. View

Bhadoria A, Kasar P, Toppo N, Bhadoria P, Pradhan S, Kabirpanthi V . Prevalence of hypertension and associated cardiovascular risk factors in Central India. J Family Community Med. 2014; 21(1):29-38. PMC: 3966094. DOI: 10.4103/2230-8229.128775. View

Malson J, Sims K, Murty R, Pickworth W . Comparison of the nicotine content of tobacco used in bidis and conventional cigarettes. Tob Control. 2001; 10(2):181-3. PMC: 1747555. DOI: 10.1136/tc.10.2.181. View

10.

Anchala R, Kannuri N, Pant H, Khan H, Franco O, Di Angelantonio E . Hypertension in India: a systematic review and meta-analysis of prevalence, awareness, and control of hypertension. J Hypertens. 2014; 32(6):1170-7. PMC: 4011565. DOI: 10.1097/HJH.0000000000000146. View

11.

Jayawardana N, Jayalath W, Madhujith W, Ralapanawa U, Jayasekera R, Alagiyawanna S . Aging and obesity are associated with undiagnosed hypertension in a cohort of males in the Central Province of Sri Lanka: a cross-sectional descriptive study. BMC Cardiovasc Disord. 2017; 17(1):165. PMC: 5480166. DOI: 10.1186/s12872-017-0600-8. View

12.

Oparil S, Acelajado M, Bakris G, Berlowitz D, Cifkova R, Dominiczak A . Hypertension. Nat Rev Dis Primers. 2018; 4:18014. PMC: 6477925. DOI: 10.1038/nrdp.2018.14. View

13.

Walekhwa S, Kisa A . Tobacco Use and Risk Factors for Hypertensive Individuals in Kenya. Healthcare (Basel). 2021; 9(5). PMC: 8157158. DOI: 10.3390/healthcare9050591. View

14.

Lastra G, Syed S, Kurukulasuriya L, Manrique C, Sowers J . Type 2 diabetes mellitus and hypertension: an update. Endocrinol Metab Clin North Am. 2014; 43(1):103-22. PMC: 3942662. DOI: 10.1016/j.ecl.2013.09.005. View

15.

West R . Tobacco smoking: Health impact, prevalence, correlates and interventions. Psychol Health. 2017; 32(8):1018-1036. PMC: 5490618. DOI: 10.1080/08870446.2017.1325890. View

16.

Chen S, Lo T, Chang J, Kuo H . Variations in aging, gender, menopause, and obesity and their effects on hypertension in taiwan. Int J Hypertens. 2014; 2014:515297. PMC: 4243128. DOI: 10.1155/2014/515297. View

17.

Landsberg L, Aronne L, Beilin L, Burke V, Igel L, Lloyd-Jones D . Obesity-related hypertension: pathogenesis, cardiovascular risk, and treatment: a position paper of The Obesity Society and the American Society of Hypertension. J Clin Hypertens (Greenwich). 2013; 15(1):14-33. PMC: 8108268. DOI: 10.1111/jch.12049. View

18.

Petrie J, Guzik T, Touyz R . Diabetes, Hypertension, and Cardiovascular Disease: Clinical Insights and Vascular Mechanisms. Can J Cardiol. 2018; 34(5):575-584. PMC: 5953551. DOI: 10.1016/j.cjca.2017.12.005. View

19.

Faulkner J, Belin de Chantemele E . Sex Differences in Mechanisms of Hypertension Associated With Obesity. Hypertension. 2017; 71(1):15-21. PMC: 5730468. DOI: 10.1161/HYPERTENSIONAHA.117.09980. View

20.

Chezhian C, Murthy S, Prasad S, Kasav J, Mohan S, Sharma S . Exploring Factors that Influence Smoking Initiation and Cessation among Current Smokers. J Clin Diagn Res. 2015; 9(5):LC08-12. PMC: 4484092. DOI: 10.7860/JCDR/2015/12047.5917. View