乌干达农村地区联合吸烟与大量饮酒对高血压患病率的相加交互作用：一项基于社区的横断面研究。

Additive interaction of conjoint tobacco smoking and heavy drinking on hypertension prevalence in rural Uganda: a community-based cross-sectional study.

作者信息

Masengere Paineto, Halbesma Nynke, Ndejjo Rawlance, Balugaba Bonny Enock, Wanyenze Rhoda K, Nuwaha Fred, Bastiaens Hilde, Musinguzi Geofrey

机构信息

Department of Disease Control and Environmental Health, Makerere University School of Public Health, Kampala, Uganda.

Centre for Population Health Sciences, Usher Institute, University of Edinburgh, Edinburgh, UK.

出版信息

BMC Public Health. 2025 Jan 17;25(1):201. doi: 10.1186/s12889-025-21429-9.

DOI:10.1186/s12889-025-21429-9

PMID:39833763

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11744800/

Abstract

BACKGROUND

The prevalence of hypertension is high in Uganda, which places a significant burden on an already strained healthcare system. The behavioural risk factors, such as unhealthy diet, tobacco use, physical inactivity, and heavy drinking, contribute to hypertension development and complications. This study explored the associations of combined tobacco smoking and heavy alcohol consumption with existing hypertension in a community-based cross-sectional study conducted in two rural districts of Uganda.

METHODS

We analysed data collected between December 2018 and January 2019 from 4,372 adults aged 25-70 from 3,689 random households in the Mukono and Buikwe districts, Uganda. Using logistic regression, crude, and adjusted odds ratios were calculated to describe the associations between participant characteristics, smoking, drinking behaviours, and high blood pressure (HBP). To determine effect modification due to combined tobacco smoking and heavy drinking, the relative excess risk due to interaction (RERI) was computed. All analyses were performed via R programming software version 4.2.3.

RESULTS

HBP was prevalent in 23% of the participants. Smokers were 1.36 times more likely to have HBP than non-smokers (Crude OR, 1.36; 95% CI, 1.04-1.76). Compared with non-drinkers, moderate alcohol drinkers were 1.45 times more likely to have HBP (AOR, 1.45; 95% CI, 1.18-1.79), and heavy drinkers were 2.53 times more likely to have HBP (AOR, 2.53; 95% CI, 1.92-3.32). The RERI indicated an additive interaction effect between smoking and heavy drinking, with conjoint smokers and heavy drinkers having 45% higher odds of having HBP than the summation of the individual risk due to smoking and heavy drinking.

CONCLUSION

Tobacco smoke interacts with heavy alcohol consumption to increase the risk of increased blood pressure (BP) when it cooccurs. Integrated intervention strategies targeting both smoking and heavy drinking are essential for reducing the incidence of hypertension in rural Uganda.

摘要

背景

乌干达高血压患病率很高，这给本就不堪重负的医疗系统带来了巨大负担。不健康饮食、吸烟、缺乏体育锻炼和大量饮酒等行为风险因素会导致高血压的发生和并发症。在乌干达两个农村地区开展的一项基于社区的横断面研究中，本研究探讨了吸烟与大量饮酒相结合与现患高血压之间的关联。

方法

我们分析了2018年12月至2019年1月期间从乌干达穆科诺区和布基韦区3689个随机家庭中收集的4372名年龄在25至70岁之间成年人的数据。使用逻辑回归计算粗比值比和调整后的比值比，以描述参与者特征、吸烟、饮酒行为与高血压（HBP）之间的关联。为了确定吸烟与大量饮酒相结合产生的效应修正，计算了交互作用所致的相对超额危险度（RERI）。所有分析均通过R编程软件版本4.2.3进行。

结果

23%的参与者患有高血压。吸烟者患高血压的可能性是非吸烟者的1.36倍（粗比值比，1.36；95%置信区间，1.04 - 1.76）。与不饮酒者相比，适度饮酒者患高血压的可能性高1.45倍（调整后比值比，1.45；95%置信区间，1.18 - 1.79），大量饮酒者患高血压的可能性高2.53倍（调整后比值比，2.53；95%置信区间，1.92 - 3.32）。RERI表明吸烟与大量饮酒之间存在相加交互作用，吸烟且大量饮酒者患高血压的几率比吸烟和大量饮酒各自所致个体风险之和高45%。