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Does cigarette smoking exacerbate the effect of blood pressure on the risk of cardiovascular and all-cause mortality among hypertensive patients?
MedLine Citation:
PMID:  23032144     Owner:  NLM     Status:  Publisher    
OBJECTIVE:: To examine the risk of cigarette smoking on cardiovascular disease (CVD) and all-cause mortality among hypertensive patients. METHODS:: We conducted a prospective cohort study among 36 943 hypertensive patients aged at least 40 years. Data on smoking and other variables were obtained in 1991 and follow-up evaluation was conducted in 1999-2000. RESULTS:: During a median follow-up of 8.2 years, we documented 7194 deaths among 36 943 hypertensive patients. Compared with never-smokers, the multivariate-adjusted relative risks (MRRs) [95% confidence intervals (CIs)] for CVD mortality were 1.19 (1.07, 1.31) and 1.33 (1.23, 1.45) for those who smoked 0.1-19 pack-years and at least 20 pack-years (P for linear trends <0.001 for all). A similar pattern was observed for all-cause mortality. A dose-response association between pack-years smoked and risk of CVD and all-cause mortality (all P ≤0.01) was found among the SBP groups (140-159, 160-179, and ≥180 mmHg), DBP groups (<90, 90-94, and 100-109 mmHg), and pulse pressure groups (50-59, 60-69, and ≥70 mmHg). In addition, compared to never-smokers with stage 1 hypertension, MRRs of CVD and all-cause mortality for those who smoked at least 20 pack-years with stage 3 hypertension were remarkably increased to 3.06 (2.64, 3.54) and 2.51 (2.24, 2.80), respectively. CONCLUSIONS:: Smoking not only significantly increased the risk of CVD and all-cause mortality among hypertensive groups, but the synergistic effect on the risk of CVD and all-cause mortality existed between cigarette smoking and blood pressure category. Therefore, apart from hypertension management, smoking cessation should be an essential component for preventing deaths related to smoking.
Zeng Ge; Yongchen Hao; Jie Cao; Jianxin Li; Jichun Chen; Jianfeng Huang; Xigui Wu; Dongfeng Gu
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-10-1
Journal Detail:
Title:  Journal of hypertension     Volume:  -     ISSN:  1473-5598     ISO Abbreviation:  J. Hypertens.     Publication Date:  2012 Oct 
Date Detail:
Created Date:  2012-10-3     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8306882     Medline TA:  J Hypertens     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Department of Evidence Based Medicine, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China.
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