Smoking cessation and the odds of developing hypertension in a working-age male population; the impact of body weight changes.

BACKGROUND: Smoking elevates blood pressure (BP) whereas smoking cessation increases body weight (BW), which predisposes new quitters to the development of hypertension. This study aimed to investigate the effect of smoking cessation and subsequent BW change on the odds of developing hypertension. METHODS: A total of 10,354 Japanese male workers without hypertension who underwent a baseline annual medical checkup were followed up for three years to detect the development of hypertension. They were divided into six groups according to their smoking status (non-smokers, new quitters, or continuous smokers) and BW change (≥3 kg or <3 kg) during the follow-up period. Logistic regression analysis was used to calculate odds ratio (OR) for developing hypertension. RESULTS: During the follow-up period, 1,032 participants (mean age, 38.4 ± 8.8 years) developed hypertension. After adjusting for multiple potential confounders, the odds of developing hypertension were significantly higher in new quitters with BW gains ≥3 kg (OR, 2.95, 95% confidence interval [CI], 1.37-6.35) compared to non-smokers with BW gains <3 kg. However, increased odds of developing hypertension were not observed in those with BW gains <3 kg (OR, 0.90, 95% CI, 0.52-1.58). Continuous smokers were at increased odds of developing hypertension regardless of their BW changes (BW gain <3 kg, OR, 1.35, 95% CI, 1.13-1.61 vs BW gain ≥3 kg, OR, 1.90, 95% CI, 1.43-2.52). CONCLUSIONS: The odds of developing hypertension were increased in new quitters only when their BW gain was not controlled after smoking cessation.

Dyslipidemia and the Risk of Developing Hypertension in a Working-Age Male Population.

BACKGROUND: Hypertension is one of the main comorbidities associated with dyslipidemia. This study aimed to examine the extent to which dyslipidemia increases the risk of developing hypertension in a Japanese working-age male population. METHODS AND RESULTS: We analyzed data from 14 215 nonhypertensive male workers (age 38±9 years) who underwent annual medical checkups. Subjects were followed up for a median of 4 years to determine new-onset hypertension, defined as blood pressure (BP) ≥140/90 mm Hg or use of antihypertensive medication. The associations between serum lipid levels and development of hypertension were examined. During the follow-up period, 1483 subjects developed hypertension. After adjusting for age, body mass index, impaired fasting glucose/diabetes, baseline BP category, alcohol intake, smoking, exercise, and parental history of hypertension, subjects with a total cholesterol (TC) level ≥222 mg/dL were at a significantly increased risk of developing hypertension (hazard ratio: 1.28; 95% CI: 1.06-1.56) compared to subjects with a TC level ≤167 mg/dL. Similar results were observed for subjects with high low-density lipoprotein cholesterol (LDLC) and non-high-density lipoprotein cholesterol (HDLC) levels. A U-shaped relationship was found between HDLC level and risk of hypertension; compared to the third quintile, the multiadjusted hazard ratio was 1.22 (95% CI: 1.03-1.43) in the lowest quintile and 1.34 (95% CI: 1.12-1.60) in the highest quintile. CONCLUSIONS: Elevated serum levels of TC, LDLC, and non-HDLC were associated with an increased risk of hypertension in working-age Japanese men. For HDLC, risk of hypertension was increased at both low and high levels.

A Proposal for the Optimal Management Target for Serum Non-High-Density Lipoprotein Cholesterol Level in Low-Risk Japanese Workers.

AIM: The Japan Atherosclerosis Society Guidelines for the Diagnosis and Prevention of Atherosclerotic Cardiovascular Diseases 2012 (JAS Guidelines 2012) indicate that the management target for serum non-high-density lipoprotein cholesterol (non-HDLC) level is 30 mg/dL higher than that for low-density lipoprotein cholesterol (LDLC) level. However, it remains unclear whether this value is applicable to subjects at a low risk of cardiovascular disease. This study aimed to propose the optimal management target for serum non-HDLC level in low-risk Japanese subjects. METHODS: Among 20,909 subjects who underwent annual medical checkup at a Japanese company in 2008, we analyzed the data of 17,023 subjects (14,352 men, mean age 37.8±8.6 years) in risk category I according to the JAS Guidelines 2012. The correlation between LDLC and non-HDLC levels was examined. RESULTS: A strong correlation was found between LDLC and non-HDLC levels (r=0.95, p<0.001). The following regression equation for calculation of non-HDLC was obtained from linear regression analysis: non-HDLC (mg/dL)=1.09×LDLC (mg/dL)＋7.79. According to this equation, the optimal management target for non-HDLC level corresponding to that for LDLC level (160 mg/dL) was 180 mg/dL. A multiple logistic regression analysis revealed that age, obesity, habitual alcohol intake, and current smoking were significantly associated with non-HDLC ≥180 mg/dL. CONCLUSIONS: The management target for non-HDLC level is recommended to be set at 20 mg/dL higher than that for the LDLC level (i.e., 180 mg/dL) in low-risk Japanese subjects.