The Paradox Association between Smoking and Blood Pressure among Half Million Chinese People
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design and Participants
2.2. Anthropometric Measurements
2.3. Assessment of Smoking, Alcohol Consumption, and Other Covariates
2.4. Statistical Analyses
3. Results
3.1. Characteristics of the Study Population
3.2. The Association between Smoking and Blood Pressure
3.3. Interaction between Smoking and Alcohol Consumption on Blood Pressure
4. Discussion
Strengths and Limitations of the Study
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
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Non-Smokers (n = 294,715) | Ex-Smokers (n = 17,577) |
Occasional Smokers (n = 27,075) |
Regular Smokers (n = 67,914) |
p | |
---|---|---|---|---|---|
Age (years) | 50.34 ± 10.39 | 54.82 ± 10.92 | 50.37 ± 10.94 | 51.00 ± 10.24 | <0.001 |
30–49 | 145,371 (49.32) | 5827 (33.15) | 13,636 (50.36) | 56,142 (46.61) | |
50–69 | 134,612 (45.68) | 9746 (55.45) | 11,794 (43.56) | 58,260 (48.37) | |
70–79 | 14,732 (5.00) | 2004 (11.40) | 1645 (6.08) | 6046 (5.02) | |
Sex | <0.001 | ||||
Male | 27,345 (9.28) | 16,371 (93.14) | 21,980 (81.18) | 114,540 (95.09) | |
Female | 267,370 (90.72) | 1206 (6.86) | 5095 (18.82) | 5908 (4.91) | |
Education | <0.001 | ||||
Illiterate | 68,607 (23.28) | 1762 (10.02) | 2286 (8.44) | 12,617 (10.48) | |
Primary school | 89,741 (30.45) | 5701 (32.43) | 7871 (29.07) | 42,508 (35.29) | |
Middle school | 77,510 (26.30) | 5546 (31.55) | 8630 (31.87) | 40,420 (33.56) | |
High school | 42,679 (14.48) | 3056 (17.39) | 5456 (20.15) | 19,151 (15.90) | |
College and above | 16,178 (5.49) | 1512 (8.60) | 2832 (10.46) | 5752 (4.78) | |
Alcohol consumption | <0.001 | ||||
Non-drinkers | 181,790 (61.68) | 3144 (17.89) | 4783 (17.67) | 22,727 (18.87) | |
Ex-drinkers | 2802 (0.95) | 1755 (9.98) | 1460 (5.39) | 8493 (7.05) | |
Occasional drinkers | 100,743 (34.18) | 6427 (36.56) | 14,888 (54.99) | 42,889 (35.61) | |
Regular drinkers | 9380 (3.18) | 6251 (35.56) | 5944 (21.95) | 46,339 (38.47) | |
MET-hours/wk | 20.92 ± 13.01 | 20.65 ± 15.10 | 22.62 ± 14.80 | 23.57 ± 15.21 | <0.001 |
BMI (kg/m2) | 23.78 ± 3.36 | 24.33 ± 3.21 | 23.86 ± 3.19 | 23.03 ± 3.19 | <0.001 |
BMI < 18.5 | 11,625 (3.94) | 430 (2.45) | 843 (3.11) | 6310 (5.24) | |
18.5 ≤ BMI < 23.9 | 150,904 (51.20) | 7779 (44.26) | 13,531 (49.98) | 70,743 (58.73) | |
24.0 ≤ BMI < 27.9 | 99,415 (33.73) | 7115 (40.48) | 9894 (36.54) | 34,590 (28.72) | |
BMI ≥ 28.0 | 32,771 (11.12) | 2253 (12.82) | 2807 (10.37) | 8805 (7.31) | |
Hypertension | 95,935 (32.55) | 7633 (43.43) | 8945 (33.04) | 39,617 (32.89) | <0.001 |
SBP (mm Hg) | 131.13 ± 23.28 | 137.13 ± 21.45 | 132.01 ± 20.68 | 132.21 ± 20.86 | |
DBP (mm Hg) | 77.96 ± 11.87 | 81.51 ± 12.02 | 79.26 ± 11.79 | 79.26 ± 11.99 |
Men (n = 180,236) | Women (n = 279,579) | |||
---|---|---|---|---|
SBP | DBP | SBP | DBP | |
Non-smoking (n = 294,715) | - | - | - | - |
Ex-smoking (n = 17,577) | 0.11 (−0.26 to 0.48) | 0.23 * (0.01 to 0.45) | −5.93 *** (−7.09 to −4.77) | −2.41 *** (−3.05 to −1.77) |
Occasional smoking (n = 27,075) | −0.08 (−0.42 to 0.26) | −0.20 (−0.40 to 0.01) | −3.11 *** (−3.68 to −2.54) | −1.01 *** (−1.32 to −0.69) |
Regular smoking (n = 120,448) | −0.57 *** (−0.83 to −0.31) | −0.35 *** (−0.50 to −0.19) | −6.00 *** (−6.54 to −5.47) | −2.19 *** (−2.48 to −1.89) |
Men (n = 141,885) | Women (n = 273,278) | |||
---|---|---|---|---|
SBP | DBP | SBP | DBP | |
Non-smoking (n = 294,715) | - | - | - | - |
Light smoking (n = 29,498) | 0.18 (−0.15 to 0.51) | −0.09 (−0.29 to 0.10) | −5.55 *** (−6.25 to −4.84) | −2.04 *** (−2.43 to −1.66) |
Medium smoking (n = 31,058) | −0.44 ** (−0.77 to −0.12) | −0.22 * (−0.42 to −0.03) | −6.63 *** (−7.61 to −5.66) | −2.32 *** (−2.86 to −1.79) |
Heavy smoking (n = 59,892) | −1.07 *** (−1.35 to −0.78) | −0.50 *** (−0.67 to −0.33) | −6.47 *** (−7.83 to −5.10) | −2.52 *** (−3.27 to −1.77) |
Pack-years/1000 (n = 120,448) | −0.04 *** (−0.04 to −0.03) | −0.01 *** (−0.01 to −0.01) | −0.06 ** (−0.11 to −0.02) | −0.04 ** (−0.06 to −0.01) |
Non-Drinking (n = 35,208) |
Ex-Drinking (n = 12,346) |
Occasional Drinking (n = 70,516) |
Regular Drinking (n = 62,166) |
|
---|---|---|---|---|
Systolic blood pressure | ||||
Non-smoking (n = 27,345) | - | 0.66 (−0.48 to 1.80) | −2.42 *** (−2.94 to −1.90) | −0.06 (−0.71 to 0.59) |
Ex-smoking (n = 16,371) | 0.01 (−0.81 to 0.83) | −1.07 (−2.70 to 0.56) | 0.59 (−0.42 to 1.60) | 0.70 (−0.38 to 1.78) |
Occasional smoking (n = 21,980) | 0.07 (−0.68 to 0.83) | −1.54 (−3.23 to 0.14) | 0.23 (−0.66 to 1.12) | −0.11 (−1.15 to 0.94) |
Regular smoking (n = 114,540) | −1.64 *** (−2.12 to −1.17) | 0.93 (−0.30 to 2.17) | 0.98 ** (0.37 to 1.59) | 2.38 *** (1.66 to 3.10) |
Diastolic blood pressure | ||||
Non-smoking (n = 27,345) | - | 1.10 ** (0.42 to 1.77) | −0.92 *** (−1.23 to −0.61) | 1.45 *** (1.06 to 1.84) |
Ex-smoking (n = 16,371) | 0.07 (−0.42 to 0.55) | −0.26 (−1.22 to 0.71) | 0.30 (−0.30 to 0.90) | 0.50 (−0.14 to 1.14) |
Occasional smoking (n = 21,980) | 0.02 (−0.43 to 0.46) | −0.36 (−1.37 to 0.64) | −0.18 (−0.71 to 0.35) | −0.22 (−0.84 to 0.40) |
Regular smoking (n = 114,540) | −0.62 *** (−0.90 to −0.33) | −0.01 (−0.75 to 0.72) | 0.11 (−0.26 to 0.47) | 0.89 *** (0.46 to 1.31) |
Non-Drinking (n = 177,236) |
Ex-Drinking (n= 2164) |
Occasional Drinking (n= 94,431) |
Regular Drinking (n= 5748) |
|
---|---|---|---|---|
Systolic blood pressure | ||||
Non-smoking (n = 267,370) | - | −1.07 * (−2.08 to −0.07) | −2.40 *** (−2.57 to −2.23) | −3.42 *** (−4.05 to −2.79) |
Ex-smoking (n = 1206) | −6.08 *** (−7.88 to −4.27) | −1.63 (−6.09 to 2.83) | 0.12 (−2.44 to 2.67) | 3.15 (−0.94 to 7.24) |
Occasional smoking (n = 5095) | −3.57 *** (−4.62 to −2.52) | 1.14 (−1.84 to 4.12) | 0.49 (−0.81 to 1.79) | 1.93 (−0.13 to 4.00) |
Regular smoking (n = 5908) | −7.46 *** (−8.27 to −6.66) | 3.30 * (0.38 to 6.23) | 1.75 ** (0.58 to 2.91) | 5.21 *** (3.51 to 6.90) |
Diastolic blood pressure | ||||
Non-smoking (n = 267,370) | - | 0.15 (−0.40 to 0.71) | −1.16 *** (−1.26 to −1.07) | −0.55 ** (−0.89 to −0.21) |
Ex-smoking (n = 1206) | −3.01 *** (−4.00 to −2.02) | −1.16 (−3.61 to 1.28) | 1.23 (−0.17 to 2.64) | 2.23 (−0.01 to 4.48) |
Occasional smoking (n = 5095) | −1.45 *** (−2.03 to −0.87) | 0.46 (−1.18 to 2.10) | 0.73 * (0.02 to 1.44) | 0.50 (−0.63 to 1.64) |
Regular smoking (n = 5908) | −3.10 *** (−3.55 to −2.66) | 1.87 * (0.27 to 3.48) | 1.29 *** (0.65 to 1.93) | 2.62 *** (1.69 to 3.55) |
Non-Drinking (n = 29,233) |
Light Drinking (n = 17,591) |
Medium Drinking (n = 23,996) |
Heavy Drinking (n = 9082) |
|
---|---|---|---|---|
Systolic blood pressure | ||||
Non-smoking (n = 14,202) | - | −2.26 *** (−3.11 to −1.41) | 1.74 *** (0.80 to 2.67) | 3.96 *** (2.17 to 5.76) |
Light smoking (n = 13,596) | 1.01 ** (0.34 to 1.68) | −0.68 (−1.87 to 0.51) | −1.70 ** (−2.93 to −0.47) | −0.68 (−2.89 to 1.53) |
Medium smoking (n = 16,623) | −1.40 *** (−2.10 to −0.70) | 2.72 *** (1.55 to 3.89) | 0.85 (−0.34 to 2.05) | 1.96 (−0.12 to 4.05) |
Heavy smoking (n = 35,481) | −2.54 *** (−3.09 to −1.98) | 3.06 *** (2.04 to 4.09) | 1.99 *** (0.93 to 3.05) | 2.84 ** (0.94 to 4.74) |
Diastolic blood pressure | ||||
Non-smoking (n = 14,202) | - | 0.11 (−0.39 to 0.61) | 2.41 *** (1.86 to 2.96) | 4.16 *** (3.10 to 5.22) |
Light smoking (n = 13,596) | 0.63 ** (0.24 to 1.03) | −0.86 * (−1.56 to −0.15) | −1.23 ** (−1.96 to −0.51) | −1.06 (−2.36 to 0.24) |
Medium smoking (n = 16,623) | −0.53 * (−0.94 to −0.12) | 1.11 ** (0.42 to 1.80) | 0.32 (−0.38 to 1.03) | 0.59 (−0.63 to 1.82) |
Heavy smoking (n = 35,481) | −1.02 *** (−1.35 to −0.69) | 0.79 * (0.18 to 1.39) | 0.66 * (0.04 to 1.29) | 0.87 (−0.25 to 1.99) |
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Wang, M.; Li, W.; Zhou, R.; Wang, S.; Zheng, H.; Jiang, J.; Wang, S.; Yu, C.; Gao, W.; Lv, J.; et al. The Paradox Association between Smoking and Blood Pressure among Half Million Chinese People. Int. J. Environ. Res. Public Health 2020, 17, 2824. https://doi.org/10.3390/ijerph17082824
Wang M, Li W, Zhou R, Wang S, Zheng H, Jiang J, Wang S, Yu C, Gao W, Lv J, et al. The Paradox Association between Smoking and Blood Pressure among Half Million Chinese People. International Journal of Environmental Research and Public Health. 2020; 17(8):2824. https://doi.org/10.3390/ijerph17082824
Chicago/Turabian StyleWang, Mengying, Wenyong Li, Ren Zhou, Siyue Wang, Hongchen Zheng, Jin Jiang, Shengfeng Wang, Canqing Yu, Wenjing Gao, Jun Lv, and et al. 2020. "The Paradox Association between Smoking and Blood Pressure among Half Million Chinese People" International Journal of Environmental Research and Public Health 17, no. 8: 2824. https://doi.org/10.3390/ijerph17082824