Miller Connor R, Shi Hangchuan, Li Dongmei, Goniewicz Maciej L
Roswell Park Comprehensive Cancer Center, Department of Health Behavior, Buffalo, NY 14263, USA.
Department of Clinical & Translational Research, University of Rochester Medical Center, Rochester, NY 14627, USA.
Toxics. 2021 Mar 9;9(3):52. doi: 10.3390/toxics9030052.
Following their introduction a decade ago, electronic cigarettes (e-cigarettes) have grown in popularity. Given their novelty, knowledge of the health consequences of e-cigarette use remains limited. Epidemiologic studies have not comprehensively explored associations between e-cigarette use and hypertension, a highly prevalent health condition and major contributor to cardiovascular disease burden. In this study, cross-sectional associations of cigarette smoking and e-cigarette use (vaping) with self-reported diagnosed hypertension were evaluated among 19,147 18-55 year old respondents in Wave 3 (2015-2016) of the Population Assessment of Tobacco and Health Study. Multivariable analyses first modeled smoking and vaping as separate 2-category variables, then as a 6-category composite variable accounting for former smoking. After adjusting for potential confounders, current vaping (aOR = 1.31; 95%CI: 1.05-1.63) and current smoking (aOR = 1.27; 95%CI: 1.10-1.47) were both associated with higher odds of hypertension. In analyses modeling smoking and vaping compositely, respondents who were concurrently smoking and vaping had the highest odds of hypertension (aOR = 1.77; 95%CI: 1.32-2.39 [referent: never smokers]). These results differ somewhat from prior epidemiologic studies of vaping and respiratory outcomes, which consistently report smaller point estimates for current vaping than for current smoking. Our findings reinforce the uncertainty surrounding long-term health consequences of vaping, as well as highlight important distinctions between respiratory and cardiovascular outcomes when considering the harm reduction potential of e-cigarettes.
电子烟在十年前问世后，其受欢迎程度不断提高。鉴于其新颖性，关于使用电子烟对健康影响的了解仍然有限。流行病学研究尚未全面探讨使用电子烟与高血压之间的关联，高血压是一种高度普遍的健康状况，也是心血管疾病负担的主要促成因素。在这项研究中，在烟草与健康人口评估研究的第3波（2015 - 2016年）中，对19147名18 - 55岁的受访者进行了吸烟和使用电子烟（吸电子烟）与自我报告诊断高血压的横断面关联评估。多变量分析首先将吸烟和吸电子烟建模为单独的二分类变量，然后建模为一个考虑既往吸烟情况的六分类复合变量。在调整潜在混杂因素后，当前吸电子烟（调整后比值比 = 1.31；95%置信区间：1.05 - 1.63）和当前吸烟（调整后比值比 = 1.27；95%置信区间：1.10 - 1.47）均与高血压的较高几率相关。在将吸烟和吸电子烟综合建模的分析中，同时吸烟和吸电子烟的受访者患高血压的几率最高（调整后比值比 = 1.77；95%置信区间：1.32 - 2.39 [参照组：从不吸烟者]）。这些结果与先前关于吸电子烟与呼吸系统结局的流行病学研究略有不同，先前研究一致报告当前吸电子烟的点估计值比当前吸烟的点估计值小。我们的研究结果强化了围绕吸电子烟长期健康后果的不确定性，同时也凸显了在考虑电子烟的潜在危害降低作用时，呼吸系统和心血管系统结局之间的重要区别。
