The risk of hypertension in men:: direct and indirect effects of chronic smoking

Objectives To assess the risk of hypertension associated with smoking status. Design A population-based cross-sectional study in 12417 men screened for a routine medical and biological check-up provided by their medical insurance at the `Institut inter-Regional pour la Sante' (IRSA, Regional Institute for Health), a group of 10 medical centres in Western and Central France. Main outcome measures The prevalence and the relative risk of hypertension associated with smoking status. Results Overall, the prevalence of hypertension was higher in former smokers than in never smokers (13.5 versus 8.8%, P < 0.001). The risk of hypertension was higher [odds ratio (OR) 1.31 (1.13-1.52), P< 0.001] in former smokers than in never smokers, independently of age and alcohol intake. Both current and former smokers were at risk for systolic hypertension, especially those subjects aged 60 years and above. The risk of hypertension was associated with the number of cigarettes smoked [OR per 10 cigarettes smoked daily: 1.13 (1.05-1.21), P<0.001] and the duration of smoking cessation [OR 0.99 (0.98-1.00), P=0.01]. When body mass index was entered into the model, the risk of hypertension in former smokers was no longer significant; however, current smokers remained at risk for systolic hypertension. Conclusions Former smokers are at risk for hypertension, probably because of the higher prevalence of overweight and obese subjects in this group. Current smokers are also at risk for systolic hypertension, especially in those subjects aged 60 years or older. However, this risk is independent of body mass index. J Hypertens 20:187-193 (C) 2002 Lippincott Williams Wilkins.