Abstract 12158: Tobacco Smoking Strengthens the Association Between High Blood Pressure and Arterial Wall Stiffness: The Bogalusa Heart Study
Introduction: Tobacco smoking and elevated blood pressure (BP) are important risk factors of vascular stiffness. However, the synergistic effect of these two risk factors is not well known, especially for the long-term burden of elevated BP. This study assessed the hypothesis that smoking strengthens the association between long-term cumulative burden of BP since childhood and adult arterial stiffness.
Methods: The study cohort consisted of 945 adults (661 whites and 284 blacks, aged 24-43 years) who have BP measured 4-15 times since childhood (aged 4-16 years) in Bogalusa, LA since 1973. The adult arterial stiffness was measured as aorta-femoral pulse wave velocity (PWV); the total area under the curve (AUC) and incremental AUC were used as a measure of long-term burden and trends of BP, respectively.
Results: Higher systolic BP values of childhood (p=0.009), adulthood (p≤0.001), total AUC (p≤0.001) and incremental AUC (p≤0.001) were all significantly associated with increased adult PWV, after adjusting for age, race, gender, body mass index and heart rate; diastolic BP showed similar patterns of association with PWV. Furthermore, years of smoking was a significant predictor of PWV (p=0.027). In the interaction analyses, the increasing trend of PWV levels with increasing adult BP (p=0.003), total AUC (p=0.010) and incremental AUC (p=0.049) among smokers was significantly greater than that among nonsmokers.
Conclusions: These results suggest that the adverse influence of BP levels on arterial stiffness begins in childhood, and tobacco smoking accelerates this process, indicating the importance of preventive strategies in early life involving healthy lifestyles.
- © 2013 by American Heart Association, Inc.