M-P Hergens1, M Lambe, G Pershagen, W Ye. 1. Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden. maria-pia.hergens@ki.se
Abstract
BACKGROUND: The scientific evidence on whether long-term use of snuff is associated with high blood pressure is limited, inconsistent and based only on cross-sectional data. OBJECTIVE: We aimed at studying the risk of hypertension in relation to long-term use of snuff based on longitudinal data. DESIGN: Repeated health check-ups were offered to all employees in the Swedish construction industry between 1978 and 1993. Blood pressure was measured at the health check-up and information on tobacco use and other risk factors was collected through questionnaires. SETTING: In total, 120 930 never smoking men with information on blood pressure and snuff use at baseline were included. The association of high blood pressure and snuff use at baseline was estimated by logistic regression. Further, 42 055 men were identified as normotensive at baseline and had at least one subsequent health check-up. Through repeated blood pressure measurements and linkage to the Swedish National Inpatient Register, information on hypertension was obtained. Relative risk estimates were derived from Cox proportional hazards regression model. RESULTS: Almost 30% of all men had used snuff. The adjusted odds ratio of high blood pressure amongst snuff users at baseline was 1.23 (95% CI 1.15-1.33) compared to never snuff users. The relative risk of high blood pressure during follow-up was 1.39 (95% CI 1.08-1.79) amongst snuff users and 1.36 (95% CI 1.07-1.72) for hypertension as recorded in the Inpatient Register. CONCLUSION: Use of Swedish moist snuff appears to be associated with a moderately increased risk of hypertension.
BACKGROUND: The scientific evidence on whether long-term use of snuff is associated with high blood pressure is limited, inconsistent and based only on cross-sectional data. OBJECTIVE: We aimed at studying the risk of hypertension in relation to long-term use of snuff based on longitudinal data. DESIGN: Repeated health check-ups were offered to all employees in the Swedish construction industry between 1978 and 1993. Blood pressure was measured at the health check-up and information on tobacco use and other risk factors was collected through questionnaires. SETTING: In total, 120 930 never smoking men with information on blood pressure and snuff use at baseline were included. The association of high blood pressure and snuff use at baseline was estimated by logistic regression. Further, 42 055 men were identified as normotensive at baseline and had at least one subsequent health check-up. Through repeated blood pressure measurements and linkage to the Swedish National Inpatient Register, information on hypertension was obtained. Relative risk estimates were derived from Cox proportional hazards regression model. RESULTS: Almost 30% of all men had used snuff. The adjusted odds ratio of high blood pressure amongst snuff users at baseline was 1.23 (95% CI 1.15-1.33) compared to never snuff users. The relative risk of high blood pressure during follow-up was 1.39 (95% CI 1.08-1.79) amongst snuff users and 1.36 (95% CI 1.07-1.72) for hypertension as recorded in the Inpatient Register. CONCLUSION: Use of Swedish moist snuff appears to be associated with a moderately increased risk of hypertension.
Authors: Nadia A Khan; Brenda Hemmelgarn; Robert J Herman; Chaim M Bell; Jeff L Mahon; Lawrence A Leiter; Simon W Rabkin; Michael D Hill; Raj Padwal; Rhian M Touyz; Pierre Larochelle; Ross D Feldman; Ernesto L Schiffrin; Norman R C Campbell; Gordon Moe; Ramesh Prasad; Malcolm O Arnold; Tavis S Campbell; Alain Milot; James A Stone; Charlotte Jones; Richard I Ogilvie; Pavel Hamet; George Fodor; George Carruthers; Kevin D Burns; Marcel Ruzicka; Jacques DeChamplain; George Pylypchuk; Robert Petrella; Jean-Martin Boulanger; Luc Trudeau; Robert A Hegele; Vincent Woo; Phil McFarlane; Michel Vallée; Jonathan Howlett; Simon L Bacon; Patrice Lindsay; Richard E Gilbert; Richard Z Lewanczuk; Sheldon Tobe Journal: Can J Cardiol Date: 2009-05 Impact factor: 5.223
Authors: Margareta Norberg; Gunnar Lundqvist; Maria Nilsson; Hans Gilljam; Lars Weinehall Journal: Glob Health Action Date: 2011-06-03 Impact factor: 2.640
Authors: Muhammad Aziz Rahman; Nicola Spurrier; Mohammad Afzal Mahmood; Mahmudur Rahman; Sohel Reza Choudhury; Stephen Leeder Journal: PLoS One Date: 2012-01-20 Impact factor: 3.240