Association between tobacco exposure, blood pressure, and arterial stiffness in South African adults and children

IntroductionSociodemographic factors, health status and health behaviour have all been associated with arterial stiffness. We examined the association between tobacco use or exposure and pulse wave velocity (PWV, a marker of arterial stiffness) in black South African adults and children against a background of other known risk factors. MethodsTwo datasets were used: African-PREDICT (A-P; n=587 apparently healthy black adult men and women, 20-30 years) and Birth-to-Twenty-Plus (Bt20; n=95 black adult women, 28-68 years and n=47 black children, 4-10 years). A cotinine value >10 ng/ml in urine (Bt20) or serum (A-P) was considered as tobacco exposed and carotid-femoral PWV was measured using the SphygmoCor XCEL device. Regression analysis included cotinine and other known risk factors. ResultsOne third of adults (32%) and almost half of all children (45%) were tobacco exposed with the prevalence of elevated blood pressure (BP) approximately twice as high as their non-exposed counterparts (adults, p=0.014; children, p=0.017). Cotinine was the only variable that significantly associated positively with PWV in both adults and children in univariate analysis (p<0.05), but only MAP remained significant for adults in multivariate analysis (p=0.001). ConclusionsIn this sample, tobacco exposure was adversely associated with vascular health in adults and children. BP was higher in the tobacco exposed adults and children compared to their non-exposed counterparts. These findings suggest tobacco cessation programs for adults should include screening for blood pressure and consider the impact of tobacco exposure on childrens vascular health.