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      Association of Husband Smoking With Wife's Hypertension Status in Over 5 Million Chinese Females Aged 20 to 49 Years

      research-article
      , PhD 1 , 2 , , PhD 3 , , PhD 1 , 4 , , MS 1 , 4 , , PhD 1 , 2 , 5 , , MPP 6 , , MD 4 , , MD 7 , , MD 7 , , MD 7 , , PhD 8 , , PhD 1 , 2 , , MD 1 , 2 , , PhD 1 , 2 , , PhD 1 , 2 , , PhD 1 , 2 , , BS 1 , 2 , , BS 1 , 2 , , PhD 1 , 4 , , BS 1 , 2 , , MS 1 , 4 , , MS 1 , 4 , , MS 1 , 2 , , MS 1 , 2 , 4 ,
      Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease
      John Wiley and Sons Inc.
      China, cross‐sectional study, hypertension, passive smoking, Epidemiology, Lifestyle, Risk Factors, Women, Hypertension

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          Abstract

          Background

          The effect of second‐hand smoking, especially husband smoking, on wife's hypertension has not been well studied. The current study was aimed to assess the association of husband smoking with wife's hypertension among females aged 20 to 49 years.

          Methods and Results

          This study included 5 027 731 females along with their husbands from the National Free Pre‐pregnancy Checkup Projects conducted across 31 provinces in China in 2014. Smoking/passive smoking status was collected by a standard questionnaire and blood pressure was measured by an electronic device after 10 minutes rest. Odds ratios and their corresponding 95% CIs for female hypertension were estimated according to smoking status of husband and wife, husbands' smoking amount, and cumulative exposure to husband smoking. Compared with neither‐smoker group, the multivariable‐adjusted odds ratio for female hypertension was 1.28 (1.27–1.30), 1.53 (1.30–1.79), and 1.50 (1.36–1.67) in husband‐only, wife‐only, and mixed group, respectively. Furthermore, a higher risk of having hypertension was associated with amount and cumulative exposure of husband smoking. For example, compared with neither‐smoker, the multivariate‐adjusted odds ratio was 1.22 (1.19–1.25), 1.24 (1.21–1.26), 1.32 (1.26–1.37), 1.37 (1.34–1.41), and 1.75 (1.64–1.87) for females whose husband smoked 1 to 5, 6 to 10, 11 to 15, 16 to 20, and ≥21 cigarettes per day, respectively ( P for trend<0.001). Subgroup analyses identified similar results.

          Conclusions

          There were associations of husband smoking with female hypertension prevalence. A family‐based smoking restriction strategy may reduce smoking in males and improve hypertension control in females.

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          Most cited references27

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          A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010

          The Lancet, 380(9859), 2224-2260
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            Worldwide burden of disease from exposure to second-hand smoke: a retrospective analysis of data from 192 countries.

            Exposure to second-hand smoke is common in many countries but the magnitude of the problem worldwide is poorly described. We aimed to estimate the worldwide exposure to second-hand smoke and its burden of disease in children and adult non-smokers in 2004. The burden of disease from second-hand smoke was estimated as deaths and disability-adjusted life-years (DALYs) for children and adult non-smokers. The calculations were based on disease-specific relative risk estimates and area-specific estimates of the proportion of people exposed to second-hand smoke, by comparative risk assessment methods, with data from 192 countries during 2004. Worldwide, 40% of children, 33% of male non-smokers, and 35% of female non-smokers were exposed to second-hand smoke in 2004. This exposure was estimated to have caused 379,000 deaths from ischaemic heart disease, 165,000 from lower respiratory infections, 36,900 from asthma, and 21,400 from lung cancer. 603,000 deaths were attributable to second-hand smoke in 2004, which was about 1·0% of worldwide mortality. 47% of deaths from second-hand smoke occurred in women, 28% in children, and 26% in men. DALYs lost because of exposure to second-hand smoke amounted to 10·9 million, which was about 0·7% of total worldwide burden of diseases in DALYs in 2004. 61% of DALYs were in children. The largest disease burdens were from lower respiratory infections in children younger than 5 years (5,939,000), ischaemic heart disease in adults (2,836,000), and asthma in adults (1,246,000) and children (651,000). These estimates of worldwide burden of disease attributable to second-hand smoke suggest that substantial health gains could be made by extending effective public health and clinical interventions to reduce passive smoking worldwide. Swedish National Board of Health and Welfare and Bloomberg Philanthropies. Copyright © 2011 Elsevier Ltd. All rights reserved.
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              Passive smoking and impaired endothelium-dependent arterial dilatation in healthy young adults.

              Passive smoking has been linked to an increased risk of dying from atherosclerotic heart disease. Since endothelial dysfunction is an early feature of atherogenesis and occurs in young adults who actively smoke cigarettes, we hypothesized that passive smoking might also be associated with endothelial damage in healthy young-adult nonsmokers. We studied 78 healthy subjects (39 men and 39 women) 15 to 30 years of age (mean +/- SD, 22 +/- 4): 26 control subjects who had never smoked or had regular exposure to environmental tobacco smoke, 26 who had never smoked but had been exposed to environmental tobacco smoke for at least one hour daily for three or more years, and 26 active smokers. Using ultrasonography, we measured the brachial-artery diameter under base-line conditions, during reactive hyperemia (with flow increase causing endothelium-dependent dilatation), and after sublingual administration of nitroglycerin (an endothelium-independent dilator). Flow-mediated dilatation was observed in all control subjects (8.2 +/- 3.1 percent; range, 2.1 to 16.7) but was significantly impaired in the passive smokers (3.1 +/- 2.7 percent; range, 0 to 9; P < 0.001 for the comparison with the controls) and in the active smokers (4.4 +/- 3.1 percent; range, 0 to 10; P < 0.001 for the comparison with the controls; P = 0.48 for the comparison with the passive smokers). In the passive smokers, there was an inverse relation between the intensity of exposure to tobacco smoke and flow-mediated dilatation (r = -0.67, P < 0.001). In contrast, dilatation induced by nitroglycerin was similar in all groups. Passive smoking is associated with dose-related impairment of endothelium-dependent dilatation in healthy young adults, suggesting early arterial damage.
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                Author and article information

                Contributors
                nfpcc_ma@163.com , genetic88@126.com
                Journal
                J Am Heart Assoc
                J Am Heart Assoc
                10.1002/(ISSN)2047-9980
                JAH3
                ahaoa
                Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease
                John Wiley and Sons Inc. (Hoboken )
                2047-9980
                20 March 2017
                March 2017
                : 6
                : 3 ( doiID: 10.1002/jah3.2017.6.issue-3 )
                : e004924
                Affiliations
                [ 1 ] National Research Institute for Family Planning Beijing China
                [ 2 ] National Human Genetic Resources Center Beijing China
                [ 3 ] Department of Epidemiology Fuwai Hospital National Center for Cardiovascular Diseases Chinese Academy of Medical Sciences and Peking Union Medical College Beijing China
                [ 4 ] Graduate School of Peking Union Medical College Beijing China
                [ 5 ] Beijing Hypertension League Institute Beijing China
                [ 6 ] Department of Behavioral and Community Health School of Public Health University of Maryland College Park MD
                [ 7 ] Department of Maternal and Child Health National Health and Family Planning Commission of the PRC Beijing China
                [ 8 ] Center for Clinical Laboratory Beijing Shijitan Hospital Capital Medical University Beijing China
                Author notes
                [*] [* ] Correspondence to: Xu Ma, MS, National Research Institute for Family Planning, National Human Genetic Resources Center, Graduate School of Peking Union Medical College, No. 12 Dahuisi Rd, Haidian District, Beijing 100081, China. E‐mails: nfpcc_ma@ 123456163.com ; genetic88@ 123456126.com
                [†]

                Dr Yang, Dr Fangchao Liu, and Dr Long Wang contributed equally to this work.

                Article
                JAH32079
                10.1161/JAHA.116.004924
                5524022
                28320748
                2f0176a2-9c71-4722-87d8-2280542843c8
                © 2017 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

                This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial‐NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.

                History
                : 03 November 2016
                : 27 January 2017
                Page count
                Figures: 3, Tables: 8, Pages: 15, Words: 10697
                Funding
                Funded by: National Key Research and Development Program of China
                Award ID: 2016YFC1000300
                Award ID: 2016YFC1000307
                Funded by: National Natural Science Foundation
                Award ID: 81402757
                Award ID: 81600332
                Funded by: International Science and Technology Cooperation Program of China
                Award ID: 2012DFB30130
                Categories
                Original Research
                Original Research
                Hypertension
                Custom metadata
                2.0
                jah32079
                March 2017
                Converter:WILEY_ML3GV2_TO_NLMPMC version:5.1.3 mode:remove_FC converted:11.07.2017

                Cardiovascular Medicine
                china,cross‐sectional study,hypertension,passive smoking,epidemiology,lifestyle,risk factors,women

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