Racial/ethnic disparity in the associations of smoking status with uncontrolled hypertension subtypes among hypertensive subjects.
<h4>Background</h4>Racial/ethnic differences in the associations of smoking with uncontrolled blood pressure (BP) and its subtypes (isolated uncontrolled systolic BP (SBP), uncontrolled systolic-diastolic BP, and isolated uncontrolled diastolic BP (DBP)) have not been investigated among...
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2017-01-01
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| Series: | PLoS ONE |
| Online Access: | https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0182807&type=printable |
| _version_ | 1826578877654237184 |
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| author | Xuefeng Liu Tinghui Zhu Milisa Manojlovich Hillel W Cohen Dennis Tsilimingras |
| author_facet | Xuefeng Liu Tinghui Zhu Milisa Manojlovich Hillel W Cohen Dennis Tsilimingras |
| author_sort | Xuefeng Liu |
| collection | DOAJ |
| description | <h4>Background</h4>Racial/ethnic differences in the associations of smoking with uncontrolled blood pressure (BP) and its subtypes (isolated uncontrolled systolic BP (SBP), uncontrolled systolic-diastolic BP, and isolated uncontrolled diastolic BP (DBP)) have not been investigated among diagnosed hypertensive subjects.<h4>Methods</h4>A sample of 7,586 hypertensive patients aged ≥18 years were selected from the National Health and Nutrition Examination Survey 1999-2010. Race/ethnicity was classified into Hispanic, non-Hispanic white, and non-Hispanic black. Smoking was categorized as never smoking, ex-smoking, and current smoking. Uncontrolled BP was determined as SBP≥140 or DBP≥90 mm Hg. Isolated uncontrolled SBP was defined as SBP≥140 and DBP<90 mm Hg, uncontrolled SDBP as SBP≥140 and DBP≥90 mm Hg, and isolated uncontrolled DBP as SBP<140 and DBP≥90 mm Hg. Adjusted odds ratios (ORs) with 95% confidence intervals (CIs) of uncontrolled BP and its subtypes were calculated using weighted logistic regression models.<h4>Results</h4>The interaction effect of race and smoking was significant after adjustment for the full potential confounding covariates (Adjusted p = 0.0412). Compared to never smokers, current smokers were 29% less likely to have uncontrolled BP in non-Hispanic whites (OR = 0.71, 95% CI = 0.56-0.90), although the likelihood for uncontrolled BP is the same for smokers and never smokers in Hispanics and non-Hispanic blacks. Current smokers were 26% less likely than never smokers to have isolated uncontrolled SBP in non-Hispanic whites (OR = 0.74, 95% CI = 0.58-0.95). However, current smoking is associated with an increased likelihood of uncontrolled systolic-diastolic BP in non-Hispanic blacks, and current smokers in this group were 70% more likely to have uncontrolled systolic-diastolic BP than never smokers (OR = 1.70, 95% CI = 1.10-2.65).<h4>Conclusion</h4>The associations between current smoking and uncontrolled BP differed over race/ethnicity. Health practitioners may need to be especially vigilant with non-Hispanic black smokers with diagnosed hypertension. |
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| format | Article |
| id | doaj.art-49d6adb49a5047a3ad91254ede33d66f |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2025-03-14T14:09:22Z |
| publishDate | 2017-01-01 |
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| spelling | doaj.art-49d6adb49a5047a3ad91254ede33d66f2025-02-27T05:37:44ZengPublic Library of Science (PLoS)PLoS ONE1932-62032017-01-01128e018280710.1371/journal.pone.0182807Racial/ethnic disparity in the associations of smoking status with uncontrolled hypertension subtypes among hypertensive subjects.Xuefeng LiuTinghui ZhuMilisa ManojlovichHillel W CohenDennis Tsilimingras<h4>Background</h4>Racial/ethnic differences in the associations of smoking with uncontrolled blood pressure (BP) and its subtypes (isolated uncontrolled systolic BP (SBP), uncontrolled systolic-diastolic BP, and isolated uncontrolled diastolic BP (DBP)) have not been investigated among diagnosed hypertensive subjects.<h4>Methods</h4>A sample of 7,586 hypertensive patients aged ≥18 years were selected from the National Health and Nutrition Examination Survey 1999-2010. Race/ethnicity was classified into Hispanic, non-Hispanic white, and non-Hispanic black. Smoking was categorized as never smoking, ex-smoking, and current smoking. Uncontrolled BP was determined as SBP≥140 or DBP≥90 mm Hg. Isolated uncontrolled SBP was defined as SBP≥140 and DBP<90 mm Hg, uncontrolled SDBP as SBP≥140 and DBP≥90 mm Hg, and isolated uncontrolled DBP as SBP<140 and DBP≥90 mm Hg. Adjusted odds ratios (ORs) with 95% confidence intervals (CIs) of uncontrolled BP and its subtypes were calculated using weighted logistic regression models.<h4>Results</h4>The interaction effect of race and smoking was significant after adjustment for the full potential confounding covariates (Adjusted p = 0.0412). Compared to never smokers, current smokers were 29% less likely to have uncontrolled BP in non-Hispanic whites (OR = 0.71, 95% CI = 0.56-0.90), although the likelihood for uncontrolled BP is the same for smokers and never smokers in Hispanics and non-Hispanic blacks. Current smokers were 26% less likely than never smokers to have isolated uncontrolled SBP in non-Hispanic whites (OR = 0.74, 95% CI = 0.58-0.95). However, current smoking is associated with an increased likelihood of uncontrolled systolic-diastolic BP in non-Hispanic blacks, and current smokers in this group were 70% more likely to have uncontrolled systolic-diastolic BP than never smokers (OR = 1.70, 95% CI = 1.10-2.65).<h4>Conclusion</h4>The associations between current smoking and uncontrolled BP differed over race/ethnicity. Health practitioners may need to be especially vigilant with non-Hispanic black smokers with diagnosed hypertension.https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0182807&type=printable |
| spellingShingle | Xuefeng Liu Tinghui Zhu Milisa Manojlovich Hillel W Cohen Dennis Tsilimingras Racial/ethnic disparity in the associations of smoking status with uncontrolled hypertension subtypes among hypertensive subjects. PLoS ONE |
| title | Racial/ethnic disparity in the associations of smoking status with uncontrolled hypertension subtypes among hypertensive subjects. |
| title_full | Racial/ethnic disparity in the associations of smoking status with uncontrolled hypertension subtypes among hypertensive subjects. |
| title_fullStr | Racial/ethnic disparity in the associations of smoking status with uncontrolled hypertension subtypes among hypertensive subjects. |
| title_full_unstemmed | Racial/ethnic disparity in the associations of smoking status with uncontrolled hypertension subtypes among hypertensive subjects. |
| title_short | Racial/ethnic disparity in the associations of smoking status with uncontrolled hypertension subtypes among hypertensive subjects. |
| title_sort | racial ethnic disparity in the associations of smoking status with uncontrolled hypertension subtypes among hypertensive subjects |
| url | https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0182807&type=printable |
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