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Early-onset alcohol, tobacco, and illicit drug use with age at onset of hypertension: a survival analysis

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Abstract

Purpose

To examine the associations of age when first substance use and early-onset substance use before age 18 with age at onset (AAO) of hypertension.

Methods

This study included 19,270 individuals with AAO of hypertension from the 2015–2019 National Survey on Drug Use and Health. Age when first use of 10 substance use variables included alcohol, daily cigarettes, cigars, smokeless tobacco, marijuana, cocaine, hallucinogens, lysergic acid diethylamide (LSD), inhalants, and methamphetamine use. The outcome was AAO of hypertension and variable cluster analysis was used to classify the exposures and outcome. Substance use status was classified into three categories: early-onset substance use (first used substance before age 18), late-onset substance use (first used substance after age 18), and never used.

Results

The mean AAO of hypertension was 42.7 years. Age when first use of 10 substance use variables had significant correlations with AAO of hypertension (all p values < 0.001). Individuals with early-onset alcohol, cigars, smokeless tobacco, marijuana, hallucinogens, inhalants, cocaine, LSD, and methamphetamine use revealed significantly earlier onset of hypertension than those never used. Compared with never used substances, the Cox regression model showed that early-onset alcohol, smokeless tobacco, marijuana, inhalants, and methamphetamine use had an increased risk of AAO of hypertension [hazard ratio (HR) (95%CI) = 1.22 (1.13, 1.31), 1.36 (1.24, 1.49), 1.85 (1.75, 1.95), 1.41 (1.30, 1.52), and 1.27 (1.07,1.50), respectively].

Conclusion

These findings suggest that intervention strategies or programs focusing on preventing early-onset substance use before age 18 may delay the onset of adult hypertension.

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Data availability

The data that support the findings of this study are openly available in [https://www.samhsa.gov/data/data-we-collect/nsduh-national-survey-drug-use-and-health] at https://www.samhsa.gov/.

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Acknowledgements

The authors would like to thank the support of data from the 2015-2019 National Survey on Drug Use and Health (NSDUH) dataset.

Funding

No funding was received for conducting this study.

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Authors and Affiliations

  1. Department of Family and Community Health, School of Nursing, Health Sciences Center, West Virginia University, 64 Medical Center Drive, Morgantown, WV, 26506, USA

    Kesheng Wang, Saima Shafique & Suzy Mascaro Walter

  2. Department of Health Policy and Management, School of Public Health, University of Maryland, College Park, MD, 20742, USA

    Nianyang Wang

  3. Department of Economics and Finance, College of Business and Technology, East Tennessee State University, Johnson City, TN, 37614, USA

    Xin Xie

  4. Department of Behavioral Medicine and Psychiatry, School of Medicine, Rockefeller Neuroscience Institute, West Virginia University, Morgantown, WV, 26506, USA

    Erin L. Winstanley

  5. Department of Neuroscience, West Virginia University, Morgantown, WV, 26506, USA

    Erin L. Winstanley

  6. Office of Research and Scholarly Activities, School of Nursing, Health Sciences Center, West Virginia University, 64 Medical Center Drive, Morgantown, WV, 26506, USA

    Saima Shafique & Ubolrat Piamjariyakul

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Contributions

KW accessed the data, designed the study, and conducted data analysis. SS, NW, and XX managed the literature search and drafted part of this the manuscript. SMW, UP, and ELW provided a substantive review and edit of the manuscript. All authors were involved in the critical revision of the manuscript. All authors read and approved the manuscript's submission.

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Correspondence to Kesheng Wang.

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There was an Institutional Review Board exemption for the present study since we conducted secondary data analysis using a publicly accessible database.

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The authors declare they have no financial interests.

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Wang, K., Shafique, S., Wang, N. et al. Early-onset alcohol, tobacco, and illicit drug use with age at onset of hypertension: a survival analysis. Soc Psychiatry Psychiatr Epidemiol (2023). https://doi.org/10.1007/s00127-023-02596-9

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