Hypertension:非吸烟者中血清可替宁水平与高血压相关

2013-02-18 Hypertension dxy xzdjh

吸烟是心血管疾病最大的可防危险因素。高血压是一个重大的公共健康问题,是心血管疾病、终末期肾病的危险因素,可致死亡增加。对于非吸烟者,暴露于二手烟是否增加高血压风险目前并不清楚。可替宁(Cotinine)是尼古丁在体内的主要代谢产物,曾作为主动吸烟和二手烟的烟草暴露的生物标记。美国西维吉尼亚州Alshaarawy O等研究人员对从不吸烟者的二手烟暴露水平(用血清可替宁客观衡量)与高血压之间关系进行了

吸烟是心血管疾病最大的可防危险因素。高血压是一个重大的公共健康问题,是心血管疾病、终末期肾病的危险因素,可致死亡增加。对于非吸烟者,暴露于二手烟是否增加高血压风险目前并不清楚。可替宁(Cotinine)是尼古丁在体内的主要代谢产物,曾作为主动吸烟和二手烟的烟草暴露的生物标记。美国西维吉尼亚州Alshaarawy O等研究人员对从不吸烟者的二手烟暴露水平(用血清可替宁客观衡量)与高血压之间关系进行了初步研究,结果发表在2013年1月的Hypertension杂志上。
研究者分析了全国健康和营养调查(National Health and Nutrition Examination Survey)2005-2008年的2889名非吸烟者。通过血清中可替宁水平评估非吸烟者的二手烟暴露,主要的结局是高血压(n=1004)。研究发现在从不吸烟者中,较高的可替宁水平与高血压正相关。血清可替宁水平≥0.218 ng/mL组与血清可替宁水平 ≤0.025 ng/mL组比较,高血压的多变量比值比为1.44 (95%CI,1.01–2.04)。此外,较高的血清可替宁水平也与收缩压的平均变化正相关(比值比3.24,95%CI,0.86–5.63;P=0.0061),但与舒张压水平无关。
在非吸烟者,经血清可替宁客观衡量的高二手烟暴露与收缩压和高血压有关且其独立于年龄、性别、种族、教育、饮酒、体重指数、糖化血红蛋白、总胆固醇及其他混杂因素。

Abstract
Hypertension is a major public health problem. Identifying novel risk factors for hypertension, including widely prevalent environmental exposures, is therefore important. Active smoking is a well-known risk factor for hypertension and cardiovascular diseases. However, there are no studies investigating the relationship between secondhand smoke exposure, measured objectively by serum cotinine, and high blood pressure among never smokers. We examined 2889 never smokers from the National Health and Nutrition Examination Survey 2005–2008. Our exposure of interest was secondhand smoke exposure among never smokers, estimated by serum cotinine level, and our main outcome was hypertension (n=1004). We found that in never smokers, higher serum cotinine levels were positively associated with hypertension. In comparison with those with serum cotinine levels ≤0.025 ng/mL, the multivariable odds ratio (95% confidence interval) of hypertension among those with serum cotinine levels ≥0.218 ng/mL was 1.44 (1.01–2.04). In addition, higher serum cotinine was positively associated with mean change in systolic blood pressure (odds ratio [95% confidence interval], 3.24 [0.86–5.63]; P=0.0061). However, no association was present with diastolic blood pressure. In conclusion, in never smokers, higher secondhand smoke exposure measured objectively by serum cotinine levels was found to be associated with systolic blood pressure and hypertension independent of age, sex, ethnicity, education, alcohol drinking, body mass index, glycohemoglobin, total cholesterol, and other confounders.

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    2013-11-28 feather89
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