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Abstract: PO2325

Association of Environmental Tobacco Exposure with Blood Pressure in US Children

Session Information

Category: Pediatric Nephrology

  • 1700 Pediatric Nephrology

Authors

  • Levy, Rebecca, Albert Einstein College of Medicine, Bronx, New York, United States
  • Brathwaite, Kaye E., Albert Einstein College of Medicine, Bronx, New York, United States
  • Sarathy, Harini, University of California San Francisco, San Francisco, California, United States
  • Reidy, Kimberly J., Albert Einstein College of Medicine, Bronx, New York, United States
  • Kaskel, Frederick J., Albert Einstein College of Medicine, Bronx, New York, United States
  • Melamed, Michal L., Albert Einstein College of Medicine, Bronx, New York, United States
Background

Hypertension is a leading cause of cardiovascular and kidney disease in adults, and there is evidence that pathologic sequelae begin in childhood and young adulthood. Nicotine and other tobacco compounds have a variety of toxic effects, but to date their associations with chronic hypertension is unclear, especially in pediatric populations.

Methods

We examined the association between tobacco exposure and high blood pressure (HBP) in children who participated the National Health And Nutrition Examination Survey (NHANES) during 2008-2016. Children were classified as having tobacco exposure if they had blood cotinine levels >0.05ng/dL or reported living with a smoker or smoking themselves. High blood pressure was classified according to the 2017 AAP Clinical Practice Guidelines. Analysis was conducted by logistic regression with adjustment for baseline demographics, income and other possible confounders. Subgroup and sensitivity analyses were conducted.

Results

There was a positive association of high blood pressure with tobacco exposure in the study population. After adjustment for demographics, the odds of having high blood pressure was 1.39 (95% Confidence Interval (CI) 1.04, 1.87) for any tobacco exposure compared to no smoking exposure. The association was similar across participant subgroups. The association remained significant by sensitivity analysis using cotinine exposure as a continuous variable. Separately, the odds of having high blood pressure for passive smokers was 1.35 (CI 0.983, 1.85) while the odds for active smokers was 1.71 (CI 1.14, 2.54) compared to participants with no tobacco exposure.

Conclusion

Tobacco exposure is associated with high blood pressure in US children and adolescents.

Association of Tobacco Exposure with High Blood Pressure
 Odds RatioConfidence Intervalp
Model 1 (Unadjusted)1.661.27, 2.19<0.001
Model 2 (Adjusted for age, sex, and race)1.621.22, 2.150.001
Model 3 (Adjusted for age, sex, race, BMI category, poverty-income ratio category, and survey year) 1.391.04, 1.880.029

Funding

  • Other NIH Support