Abstract
周筠,郑鸿尘,薛恩慈,王梦莹,江锦,吴涛.中老年人群中吸烟与血压关联的前瞻性队列研究[J].Chinese journal of Epidemiology,2020,41(6):896-901
中老年人群中吸烟与血压关联的前瞻性队列研究
A prospective cohort study on the association between smoking and blood pressure among middle-aged and elderly people
Received:March 12, 2020  
DOI:10.3760/cma.j.cn112338-20200312-00320
KeyWord: 吸烟  血压  前瞻性队列研究
English Key Word: Smoking  Blood pressure  Prospective cohort study
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Author NameAffiliationE-mail
Zhou Yun Beijing Tiantan Hospital, Capital Medical University, China National Clinical Research Center for Neurological Diseases, Beijing 100070, China  
Zheng Hongchen Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China  
Xue Enci Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China  
Wang Mengying Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China  
Jiang Jin Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China  
Wu Tao Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China twu@bjmu.edu.cn 
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Abstract:
      目的 吸烟是重要的心血管事件危险因素,但部分研究却发现吸烟与高血压无关,甚至吸烟者血压水平更低。吸烟与血压的关联还需要更多纵向研究证据。本研究基于中国健康与养老追踪调查(China Health and Retirement Longitudinal Survey,CHARLS)数据探索45~80岁中老年人群中吸烟对血压的影响。方法 研究对象来源于CHARLS研究中完成2011年基线和2013、2015年随访的人群。纳入完成3次调查的研究对象,采用多水平线性回归分析吸烟对血压的影响,采用含时依变量的Cox回归分析吸烟对高血压发生风险的影响,同时调整性别、年龄、文化程度、婚姻状况、BMI和饮酒。结果 本研究共纳入6 667名无心血管疾病的研究对象,平均年龄58.8岁,男性占46.3%。多水平线性回归分析显示,在调整协变量后,相对于不吸烟者,吸烟者的SBP高1.81 mmHg(95% CI:0.55~3.07 mmHg,P<0.05),DBP高0.85 mmHg(95% CI:0.10~1.60 mmHg,P<0.05)。Cox回归分析显示,吸烟与高血压发生风险的关联无统计学意义(HR=1.11,95% CI:0.89~1.38,P>0.05)。结论 在中老年人群中,吸烟与血压水平升高相关联。吸烟与高血压发生风险的关系有待进一步研究证实。
English Abstract:
      Objective Smoking is an important risk factor for cardiovascular events. However, data from some studies have shown that smoking is not associated with hypertension, and smokers may even have lower blood pressure than the non-smokers. Therefore, the association between smoking and blood pressure is yet to be further explored through longitudinal studies. This study explores the effect of smoking on blood pressure among people aged between forty five to eighty years old whose records are gathered from the China Health and Retirement Longitudinal Survey (CHARLS). Methods Participants of CHARLS who completed all three surveys from both the national baseline investigation in 2011 and the follow-up surveys in 2013 and 2015, were enrolled. Multi-level linear regression was used to analyze the association between smoking and blood pressure, and Cox regression with time-varying variables was used to analyze the association between smoking and hypertension, after the adjustment for gender, age, education level, marital status, BMI, and alcohol consumption. Results Subjects included in this study were with an average age of 58.8 years and 46.3% of them being male. After the adjustments of all the covariates, systolic and diastolic blood pressure of smokers appeared as 1.81 mmHg (95%CI: 0.55-3.07 mmHg, P<0.05) and 0.85 mmHg (95%CI: 0.10-1.60 mmHg, P<0.05), both higher than those of non-smokers, respectively. From the Cox regression analysis, data showed that smoking was not highly associated with the risk of hypertension development (HR=1.11, 95%CI: 0.89-1.38, P>0.05), statistically. Conclusions Smoking seemed to be positively correlated with the elevation of blood pressure, among individuals aged between 45 and 80 years old. However, more evidence on the association between smoking and the risk of hypertension development needs to be further explored.
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