A Prospective Study of Cigarette Smoking and Risk of 10-Years Incidence of Hypertension in men aged 20-74 years old; Yazd Healthy Heart Cohort Study (YHHC)

A Prospective Study of Cigarette Smoking and Risk of 10-Years Incidence of Hypertension in men aged 20-74 years old; Yazd Healthy Heart Cohort Study (YHHC) | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Article A Prospective Study of Cigarette Smoking and Risk of 10-Years Incidence of Hypertension in men aged 20-74 years old; Yazd Healthy Heart Cohort Study (YHHC) Seyedeh Mahdieh Namayandeh, Seyed hasan Emadi, Fatemeh Majidpour, and 2 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-4385327/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract The effects of cigarette smoking on blood pressure are complex, with evidence that smoking increases acute increase in blood pressure (BP), heart rate, risk of renovascular, malignant, and masked hypertension. We evaluated smoking status in phase I and hypertension incidence in males after 10 years using YHHC (Yazd Healthy Heart Cohort Study) data. All of normotensives participants enrolled the analysis. Univariate analysis was performed via Chi -square and student T tes and we employed a multivariable logistic regression model with the "backward" method to assess the risk of hypertension associated with smoking status while adjusting for other risk factors. out of total 446 male follow –uped during 10-years, 37 new case(31.9%) developed hypertension incidence in smoker men at the baseline. We found in Multivariate-adjusted a (aOR = 0.52,95%CI(0.29–0.94,P = 0.032) and Multivariate-adjusted b (aOR = 0.58,95%CI(0.31–1.08,P = 0.089) withStepwise Model selection variable Cigarette Smoking history don’t increase 10-years hypertension.we observed history of smoking associated with decrease hypertension incidence. Health sciences/Medical research/Epidemiology Health sciences/Medical research/Outcomes research Figures Figure 1 Figure 2 Introduction The effects of cigarette smoking on blood pressure are complex, with evidence that smoking increases acute increase in blood pressure (BP), heart rate, risk of renovascular, malignant, and masked hypertension( 1 – 5 ).Hypertension is a major risk factor for cardiovascular diseases( 6 ), heart failure( 7 ), and end-stage renal disease. It is attributed to environmental factors such as stress, obesity, physical inactivity, and heavy salt consumption( 2 ). Among these factors, cigarette smoking is an important lifestyle factor and is the most readily preventable risk factor for human death. It has detrimental effects on the health of both smokers and nonsmokers who are exposed to passive tobacco inhalation in the environment. Cigarette smoking is a strong risk factor for atherosclerosis and myocardial infarction because it increases platelet aggregation, decreases myocardial oxygen supply, increases oxygen demand, and decreases the threshold for ventricular fibrillation( 8 , 9 ). It also increases the risk of cancers of the esophagus, pancreas, bladder, kidney, cervix, and bone marrow, with 90% of individuals who have lung cancer being smokers( 8 ). Tobacco smoking temporarily increases blood pressure( 8 , 10 – 12 ), but the association between chronic smoking and hypertension according to the results of previous studies is controversial. Most of the previous studies are cross-sectional( 9 , 13 – 18 ) and could not confirm the causal relationship between smoking and hypertension incidence. Additionally, several studies that have assessed this relationship longitudinally have produced inconsistent results( 19 – 26 ) The aim of this sub-study of YHHC was to assess the relationship between smoking and hypertension incidence in a 10-year follow-up study in Yazd, Iran. Methods The present study is a sub-study of the Yazd Healthy Heart Cohort (YHHC) project. The Yazd Healthy Heart Study is a ten-year cohort study conducted in two phases. In the first phase( 27 ), 2000 participants aged 20–74 years in the city of Yazd were enrolled in the study during 2004–2005 and were followed up every year from 2009 to 2010. All demographic characteristics, lifestyle, cardiovascular risk factors, clinical cardiovascular disease, and mortality were collected and recorded by a questionnaire along with medical examinations. Subjects in the second phase were recruited again after ten years during 2014–2015 and were evaluated for the above-mentioned factors. In this analysis, people aged 20–74 years, living in the city of Yazd for at least one year in the first phase of YHHC, were included in the study, while all those who had hypertension or took medicine for hypertension in the first phase of YHHC, and all women, were excluded. A total of 848 individuals were hypertensive oadministered medicine at baseline and 1002 women were excluded from the study. Then this study was conducted on 571 normotensive men subjects during the ten-year follow-up period and 35 case didn't report their smoke status at baseline. Of the total 571 men, 125 (21.9%) were lost to follow-up. The lost to follow-up patients only visited at baseline. In total, the data of 446 men were follow- uped during 10 years were analyzed(Fig. 1 - Table 2 , 3 ). Table 2 Association between Participant'S Characteries at baseline and 10- years hypertension Variable Total(n = 446) Normotensive (n = 288) Hypertension (n = 158) Crude OR(95% CI) P-Value Age at baseline, years 43.04 ± 14.04 39.87 ± 13.65 48.81 ± 12.87 1.05(1.03–1.07) **<0.001 BMI 24.32 ± 3.65 23.69 ± 3.68 25.48 ± 3.3 1.15(1.08–1.22) **<0.001 Waist 90.46 ± 10.98 88.41 ± 10.81 94.21 ± 10.31 1.052(1.03–1.07) **<0.001 SBP, mmHg 120.6 ± 8.58 118.7 ± 8.44 124.05 ± 7.75 1.089(1.06–1.12) **<0.001 DBP, mmHg 78.4 ± 5.14 77.81 ± 5.17 79.49 ± 4.9 1.072(1.02–1.11) ** 0.001 FBS 95.67 ± 36.1 90.22 ± 26.39 105.58 ± 47.57 1.012(1.006–1.01) **<0.001 Triglycerides, mg/dl 168.13 ± 107.08 156.12 ± 100.66 189.96 ± 114.99 1.003(1.001–1.005) **0.002 Total cholesterol, mg/dl 187.67 ± 41.12 183.2 ± 40.82 195.81 ± 40.53 1.008(1.003–1.01) **0.002 HDL cholesterol, mg/dl 52.15 ± 12.95 52.71 ± 12.96 51.13 ± 12.91 0.99(0.97–1.006) **0.2 LDL cholesterol, mg/dl 101.55 ± 35.51 99.86 ± 36.22 104.65 ± 34.1 1.004(0.99–1.009) *0.18 UA 4.72 ± 1.14 4.76 ± 1.12 4.66 ± 1.17 0.92(0.78–1.1) 0.36 Physical activity, % Low 227(64.3) 136(59.9) 91(40.1) Ref Moderate + sever 126(35.7) 86(68.3) 40(31.7) 0.69(0.44–1.1) *0.12 Parental History of Hypertension Non 281(63.1) 183(65.1) 98(34.9) Ref Mother 103(23.1) 67(65) 36( 35 ) 1.003(0.62–1.61) 0.98 Father 34(7.6) 23(67.6) 11(32.4) 0.89(0.41–1.9) 0.77 Both 27(6.3) 14(51.9) 13(48.1) 1.73(0.78–3.83) *0.17 Smoke status Smoker 116(27.7) 79(68.1) 37(31.9) 0.81(0.51–1.28) Non- Smoker 303(72.3) 192(63.4) 111(36.6) Ref 0.36 BMI, body mass index; SBP, systolic blood pressure; HDL cholesterol, high-density lipoprotein cholesterol; LDL cholesterol, low-density lipoprotein cholesterol **P < 0.05, * 0.05 ≤ P < 0.2Univariate Logistic Regression, OR; Odds Ratio, CI; Confidence Interval Table 3 Association between smoking status and hypertension by multivariate logistic regression models using backward stepwise algorithm Variable Never smokers (n = 376) Current Smoker(n = 160) P-Value Total number of people with hypertension, % 111(36.3) 37(31.9) 0.36 Unadjusted OR(95%CI) 1.00(ref) 0.81(0.51–1.28) 0.36 Multivariate-adjusted a OR(95%CI) 1.00(ref) 0.52(0.29–0.94) **0.032 Multivariate-adjusted b OR(95%CI) 1.00(ref) 0.58(0.31–1.08) *0.089 a Adjusted for age, Parental History of hypertension, Waist, BMI, Physical activity, HDL, LDL, TG b Adjusted age, SBP, DBP, TG, LDL, HDL, FBS, BMI, Waist, Parental History of hypertension, Physical activity *P < 0.1, **P < 0.05, OR; Odds Ratio, CI; Confidence Interval Figure 1 We also observed that there were no statistically significant differences between the mean SBP, DBP, FBS, HDL, LDL, CHOL, age, and frequency of physical activity of the two groups, but there were statistically significant differences in the mean TG, body mass index, waist circumference, and frequency of parental history of hypertension between patients who were follow-uped and lost follow-up. We expected almost 30% of variables different between patients who were follow-uped and lost follow-up. Also, we adjusted the variables TG, body mass index, waist circumference, and parental history of hypertensionin the logistic regression model. Evaluating the Incidence of Hypertension According to the JNC7 Guideline, hypertension is defined as a systolic blood pressure ≥ 140, or a diastolic blood pressure ≥ 90, or taking antihypertensive drugs( 28 ). We measured the blood pressure of our participants using a mercury sphygmomanometer in phase one and a digital sphygmomanometer, Omron Model, Japan in recent years( 27 , 29 , 30 ). History of traditional risk factors Individuals who were taking anti-diabetic medications or had blood glucose levels above 126 mg/dL were classified as diabetic. Obesity was determined by a body mass index of 30 or higher. Family history of hypertension was categorized as having healthy first-degree relatives, a history of hypertension in one parent, or a history of hypertension in both parents based on self-reporting by participants. Cigarette smoking was defined as consuming ten or more cigarettes in the last three months at the time of study inclusion. Gender and age variables were also recorded based on individuals' phenotype and age at the time of study enrollment. Lipid profile was measured using a photometric method by a calorimetry enzyme device (CHOD-PAP)( 31 ). Data Analysis Demographic and clinical characteristics of participants at baseline were reported using descriptive statistics. Independent t-tests and chi-square tests were used for univariate analysis to investigate significant differences in risk factors between male smokers and non-smokers. A graph illustrating the 10-year incidence of high blood pressure based on smoking status in men was created using Excel software. We employed a multivariable logistic regression model with the "backward" method to assess the risk of hypertension associated with smoking status while adjusting for other risk factors. All variables with a P-value less than 0.2 were included in the model. The level of statistical significance was set at 5% for final model and the analysis was conducted using SPSS software version 26. Results Out of a total of 446 male participants without hypertension at the beginning of the study, 29.9% (160) were smokers. After ten years, 37 men (31.9%) developed hypertension (Table 1 - Fig. 2 ). Table 1 Characteristics of the study population according to smoking status at the baseline Variable Total(n = 517) Never smokers (n = 376) Current Smoker(n = 160) P-Value Age at baseline, years 43.14 ± 14.56 42.05 ± 15 45.71 ± 13.17 *0.008 Physical activity, % Low 273(64.2) 183(60.2) 90(74.4) Moderate + sever 152(35.8) 121(39.8) 31(25.6) **0.006 BMI, kg/m2 * 24.10 ± 3.74 24.32 ± 3.73 23.6 ± 3.72 *0.044 BMI, % Lean or healthy 322(60.6) 217(58.5) 105(65.6) Overweight 175( 33 ) 128(34.5) 47(29.4) Obesity 34(6.4) 26( 7 ) 8( 5 ) 0.28 Parental History of Hypertension Non 371(69.9) 268(71.8) 103(65.2) Mother 98(18.5) 60(16.1) 38(24.1) Father 34(6.4) 24(6.4) 10(6.3) Both 28(5.3) 21(5.6) 7(4.4) 0.18 Waist 89.79 ± 11.33 90.1 ± 11.26 89.08 ± 11.50 0.34 SBP, mmHg 120.42 ± 8.52 120.84 ± 8.35 119.45 ± 8.89 0.085 DBP, mmHg 78.35 ± 5.25 78.71 ± 5.06 77.5 ± 5.57 *0.014 FBS 95.15 ± 35.7 92.36 ± 29.89 96.34 ± 37.88 0.23 History of diabetes,(Yes) % 63(11.8) 45( 12 ) 18(11.3) 0.81 Triglycerides, mg/dl 161.51 ± 103.22 164.16 ± 107.28 155.28 ± 92.99 0.36 Total cholesterol, mg/dl 186.04 ± 41.23 186.13 ± 41.47 185.84 ± 40.79 0.94 HDL cholesterol, mg/dl 52.43 ± 12.82 50.20 ± 12.57 50.63 ± 13.27 *0.03 LDL cholesterol, mg/dl 100.71 ± 35.31 98.9 ± 33.69 104.98 ± 38.68 0.07 BMI, body mass index; SBP, systolic blood pressure; HDL cholesterol, high-density lipoprotein cholesterol; LDL cholesterol, low-density lipoprotein cholesterol P < 0.05, * T-test Independent, **Chi-Square test Figure 2 . Table 1 The Mean age of men at the beginning of the study was 43.14 ± 14.56, and smoking men were on average 2 years older than non-smokers (P = 0.008). The average body mass index of smoking men was statistically significantly lower than that of non-smokers (P = 0.044). Additionally, the average waist circumference of smoking men was lower than that of non-smokers, but this difference was not statistically significant. The mean systolic and diastolic blood pressure, triglyceride, and total cholesterol were lower in smoking men compared to non-smokers. The levels of HDL and LDL were higher in smoking men, and the only statistically significant differences were in mean diastolic blood pressure and HDL between smoking and non-smoking men.From a total of 160 smoking men at the beginning of the study, 64.2% had low physical activity, 29.4% were overweight, and 5% were obese. 11.3% reported a history of diabetes, and most of the smoking men had a history of diabetes. Additionally, smoking men had less physical activity than non-smokers (P = 0.006). 5.6% of non-smoking men and 4.4% of smoking men reported that both their parents had a history of hypertension (Table 2 ). Table 2 . The results of univariate logistic regression showed that the variables measured at baseline, including age, body mass index, waist circumference, systolic blood pressure, diastolic blood pressure, blood sugar, triglycerides, and total cholesterol, were significantly related to the incidence of hypertension at a 5% significance level. Table 3 . In Table 3 , participant non-smokers were used as controls. The adjusted odds ratio (OR) indicated that the occurrence of hypertension was lower in smokers compared to non-smokers in all models. Here, we conducted two logistic regression models to explore the impact of smoking on the likelihood of developing high blood pressure. In model 1, we analyzed the influence of smoking while adjusting for variables related to follow-up and loss of follow-up. In model 2, we investigated the relationship between smoking and the occurrence of hypertension while adjusting for variables that could affect hypertension (Table 2 ). The OR ranged from 0.81 in the unadjusted model to 0.52 in the adjusted multivariable model. This decrease in the incidence of high blood pressure was significant in model a and in model B where it was significant at the 10% level(Table 3 ). Discussion Multivariate logistic regression with backward LR models revealed significant Negative correlation between smoking and hypertension incidence in our 10 year follow-up study. Consistent with our findings ,Several longitudinal studies have evaluated this relationship. Some studies reported negative correlation for example a longitudinal study on 74,743 Korean adults with a mean 29 month follow up reported that cotinine-verified new smokers and sustained smokers had a lower risk for incident hypertension, especially men smokers, compared with non-smokers( 19 ) also a longitudinal study with 2,427 Turkish adults showed current smoking is inversely associated with hypertension incidence by reducing waist circumference specially in women( 26 ) But sohn( 20 ) and our study reported no effect of weight in the in correlation between smoking and hypertension. Although the effect of smoking on BMI or body weight is inconsistent( 19 , 25 , 32 – 34 ) obesity is an important risk factor of hypertension incidence in the literature( 8 , 35 ) and in our study. Some studies showed positive correlation between smoking and incident hypertension. A longitudinal study in male Japanese workers with 14-year follow-up reported positive relationship between smoking and onset of hypertension by pooled logistic regression analysis( 24 ). A longitudinal study with 28,577 males from a Chinese longitudinal survey with a long follow-up period assess this correlation with two independent variables in three age categories; current number of cigarettes smoked per day(CCS) that obtained from the questionnaire and life-course-adjusted number of cigarettes smoked per day(LCS) calculated by dividing the total number of cigarettes smoked by the survival time from birth. There was no significant association between smoking and hypertension incidence in the age category lower than 35. In age categories higher than 35 smoking increases the risk of hypertension incidence with respect to LCS and the risk increased with age but when they considered CCS, smoking reduced the risk of incident hypertension. LCS indicated the smoking status more real and reasonable. By comparison between LCS and CCS, this study explained why some studies reported smoking reduces the risk of incident hypertension. So we should consider the effects of smoking on human health over the long time and from a life-course perspective( 21 ). Some studies reported no significant correlation. Sohn reported no relation of smoking to hypertension in a large number of Indonesian men by fixed-effect models and panel data analysis with a long follow-up period( 20 ). A large Mendelian randomization meta-analysis reported that smoking exposure in ever smokers increased resting heart rate but it didn’t have significant association with SBP, DBP and hypertension. This meta-analysis performed according to the genetic variant rs16969968/rs1051730 as a strong indicator of smoking heaviness but this genetic variant isn’t associated with smoking status and just assessed in ever smokers. This study suggested that there may not be a strong association between smoking and blood pressure and more attention should be paid to resting heart rate as a predictor of heart events. Also several studies have shown resting hear rate as an independent cardiovascular risk factor even after adjusting other risk factors such as blood pressure( 22 ). Some mechanisms explain the effect of smoking on hypertension. Tobacco smoking causes metabolic dysregulation, increases mitochondrial oxidative stress, reduces endothelial NO, impairs endothelial-dependent relaxation leading to endothelial dysfunction and development of hypertension ( 27 ) also nicotine stimulates release of catecholamines from sympathetic nervous system and causes acute increase in inotrope effect, heart rate and blood pressure. But Nicotine has biphasic action on sympathetic neurons; Ganglionic stimulation followed by depressant effect( 8 ). Also some studies reported the tolerance to nicotine effect( 19 ). Chance of exposure to smoking in masked hypertensives is more often than normotensives (mean difference 18%; P < 0.03). therefore, masked hypertension occurs more in smokers( 36 ). Both Smoking and hypertension are associated with genetic differences. Multiple loci are identified that have a role in blood pressure regulation and some of these loci have significant interaction with smoking status. So there may be genetic association between smoking and blood pressure( 37 ). Conclusions A history of cigarette smoking does not increase the incidence of hypertension over a 10-year period. However, smoking is a major risk factor for cardiovascular diseases. Smokers should not be complacent because smoking can still affect metabolic risk factors such as hypertension, ultimately increasing the risk of cardiovascular disease. Study limitations: One important limitation of our study is that we only analyzed two sets of data (at baseline and at the end of the 10-year follow-up period). We did not take into account changes in smoking status during the middle years of the study, so changes in smoking habits were not considered. Additionally, we did not analyze smoking quantitatively based on smoking duration and pack-years, which prevented us from discussing the dose-response effect of smoking on blood pressure over time. Additionally, women were not included in this study. The rate of smoking reported among the women in this study was very low, and the occurrence of hypertension in women who smoked was so minimal, which skewed the analysis results. It appears that women may have underreported smoking due to social stigmas. Suggestions: We recommend studying cohorts of smokers while considering both qualitative and quantitative aspects of smoking, as well as genetic variations within the population. Furthermore, it would be beneficial to measure various outcomes that may result from smoking. Declarations Conflict of interest The authors have no conflicts of interest to declare for this study. Statement This manuscript is original, has not been published before, and is not under consideration for ‎publication anywhere. Acknowledgements This work was supported by Modeling in Health Research Center, Institute for Futures Studies in Health, Departments of Biostatistics and Epidemiology Shahid Sadoughi University of Medical Sciences, Yazd . Authors’ contributions: SM.N Conceptualization, Collecting data, Critical revision, methodology, Analysis of data, SH.E wrote the main manuscript text, Critical revision, F.M Participate in writting the main manuscript text, Collecting data, Analysis of data, SM.S and MH.S Critical revision, All authors reviewed the manuscript. Funding: This work was supported by Shahid Sadoughi University of Medical sciences Yazd, Iran. Competing Interests : The authors declare that they have no competing interests Patient and public involvement : Patients and/or the public were not involved in design, plan, manage and carry out research. Ethics approval and consent to participate The present study was ethically approved by the ShahidSadoughi University of Medical Sciences’ ethics committee (ethics code: IR.SSU.SPH.REC.1400.052). All provisions of the Declaration of Helsinki adhered in our study, especially appropriate ethical and scientific review. The study is a sub-study of the YHHC cohort study. Informed consent was obtained from each patient at the beginning of this study. All patients signed a predefined consent form, specifically allowing for the usage of their clinical data. Availability of Data and Materials The data that support the findings of this study are available from [Dr Seyedeh Mahdieh Namayandeh ] but restrictions apply to the availability of these data, which were used under license for the current study, and so are not publicly available. Data are however available from the authors upon reasonable request and with permission of [Dr Seyedeh Mahdieh Namayandeh ]. References Primatesta P, Falaschetti E, Gupta S, Marmot MG, Poulter NR. Association between smoking and blood pressure: evidence from the health survey for England. Hypertension. 2001;37(2):187–93. Peralta CA, Norris KC, Li S, Chang TI, Tamura MK, Jolly SE, et al. Blood pressure components and end-stage renal disease in persons with chronic kidney disease: the Kidney Early Evaluation Program (KEEP). Archives of internal medicine. 2012;172(1):41–7. Rhee M-Y, Na S-H, Kim Y-K, Lee M-M, Kim H-Y. Acute effects of cigarette smoking on arterial stiffness and blood pressure in male smokers with hypertension. American journal of hypertension. 2007;20(6):637–41. Virdis A, Giannarelli C, Fritsch Neves M, Taddei S, Ghiadoni L. Cigarette smoking and hypertension. Current pharmaceutical design. 2010;16(23):2518–25. mohammed Ali W. What's New in Cigarette Smoking and Hypertension? Kirkuk Journal of Medical Sciences. 2024;12(1). Stanaway JD, Afshin A, Gakidou E, Lim SS, Abate D, Abate KH, et al. Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks for 195 countries and territories, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017. The Lancet. 2018;392(10159):1923–94. Kannan A, Janardhanan R. Hypertension as a risk factor for heart failure. Current hypertension reports. 2014;16:1–8. Kumar V, Abbas A, Aster J. Robbins and cotran pathologic basis of disease ninth edition. Amsterdam, Netherlands; 2015. Pankova A, Kralikova E, Fraser K, Lajka J, Svacina S, Matoulek M. No difference in hypertension prevalence in smokers, former smokers and non-smokers after adjusting for body mass index and age: a cross-sectional study from the Czech Republic, 2010. Tobacco induced diseases. 2015;13:1–7. General USPHSOotS. How tobacco smoke causes disease: the biology and behavioral basis for smoking-attributable disease: a report of the Surgeon General: US Department of Health and Human Services, Public Health Service, Office of … Dimitriadis K, Tsioufis K, Konstantinidis D, Kalos T, Fragoulis C, Konstantinou K, et al. ACUTE DETRIMENTAL EFFECTS OF E-CIGARETTE AND TOBACCO CIGARETTE SMOKING ON BLOOD PRESSURE AND SYMPATHETIC NERVE ACTIVITY IN HEALTHY SUBJECTS. Journal of Hypertension. 2018;36:e245. Leone A. Smoking and hypertension: independent or additive effects to determining vascular damage? Current vascular pharmacology. 2011;9(5):585–93. Kim SH, Lee JS. The association of smoking and hypertension according to cotinine-verified smoking status in 25,150 Korean adults. Clinical and experimental hypertension. 2019;41(5):401–8. Kim BJ, Han JM, Kang JG, Kim BS, Kang JH. Association between cotinine-verified smoking status and hypertension in 167,868 Korean adults. Blood Pressure. 2017;26(5):303–10. Mehboudi M, Nabipour I, Vahdat K, Darabi H, Raeisi A, Mehrdad N, et al. Inverse association between cigarette and water pipe smoking and hypertension in an elderly population in Iran: Bushehr elderly health programme. Journal of human hypertension. 2017;31(12):821–5. Li G, Wang H, Wang K, Wang W, Dong F, Qian Y, et al. The association between smoking and blood pressure in men: a cross-sectional study. BMC Public Health. 2017;17:1–6. Alomari MA, Al-Sheyab NA. Cigarette smoking lowers blood pressure in adolescents: the Irbid-TRY. Inhalation Toxicology. 2016;28(3):140–4. Okubo Y, Miyamoto T, Suwazono Y, Kobayashi E, Nogawa K. An association between smoking habits and blood pressure in normotensive Japanese men. Journal of human hypertension. 2002;16(2):91–6. Kim BJ, Seo DC, Kim BS, Kang JH. Relationship between cotinine-verified smoking status and incidence of hypertension in 74,743 Korean adults. Circulation Journal. 2018;82(6):1659–65. Sohn K. Relationship of smoking to hypertension in a developing country. Global heart. 2018;13(4):285–92. Gao K, Shi X, Wang W. The life-course impact of smoking on hypertension, myocardial infarction and respiratory diseases. Scientific reports. 2017;7(1):4330. Linneberg A, Jacobsen RK, Skaaby T, Taylor AE, Fluharty ME, Jeppesen JL, et al. Effect of smoking on blood pressure and resting heart rate: a Mendelian randomization meta-analysis in the CARTA consortium. Circulation: Cardiovascular Genetics. 2015;8(6):832–41. Kaneko M, Oda E, Kayamori H, Nagao S, Watanabe H, Abe T, et al. Smoking was a possible negative predictor of incident hypertension after a five-year follow-up among a general Japanese population. Cardiology Research. 2012;3(2):87. Dochi M, Sakata K, Oishi M, Tanaka K, Kobayashi E, Suwazono Y. Smoking as an independent risk factor for hypertension: a 14-year longitudinal study in male Japanese workers. The Tohoku journal of experimental medicine. 2009;217(1):37–43. Kadonaga Y, Dochi M, Sakata K, Oishi M, Tanaka K, Morimoto H, et al. Longitudinal evaluation of the effect of smoking initiation on body weight, blood pressure, and blood biochemistry. Preventive medicine. 2009;48(6):567–71. Onat A, Uğur M, Hergenç G, Can G, Ordu S, Dursunoğlu D. Lifestyle and metabolic determinants of incident hypertension, with special reference to cigarette smoking: a longitudinal population-based study. American journal of hypertension. 2009;22(2):156–62. Namayandeh SM, Sadr S, Ansari Z, Rafiei M. A cross-sectional study of the prevalence of coronary artery disease traditional risk factors in Yazd urban population, Yazd healthy heart project. 2011. Whelton PK, Carey RM, Aronow WS, Casey DE, Collins KJ, Himmelfarb CD, et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Journal of the American College of Cardiology. 2018;71(19):e127-e248. Abbas R, Mahdieh N, Abdoreza R, Hamidreza T, Mahmood S. Longitudinal Study of Blood Pressure during 8 Years; Patterns and Correlates: Yazd Healthy Heart Project. J Hypertens. 2016;5(215):2167-1095.1000215. Mohammadhoseini M, Namayandeh SM, Fallahzadeh H, Majidpour F, Sadr-Bafghi SM, Soltani M, et al. Population attributable risk of hyperuricemia in hypertension incidence in 20-74-year-old population during a 10-year longitudinal cohort: yazd healthy heart cohort. Iranian Journal of Public Health. 2020;49(10):1977. Namayandeh SM, Karimi A, Fallahzadeh H, Rahmanian M, Bafghi SMS, Soltani M, et al. The incidence rate of diabetes mellitus (type II) and its related risk factors: A 10-year longitudinal study of Yazd Healthy Heart Cohort (YHHC), Iran. Diabetes & Metabolic Syndrome: Clinical Research & Reviews. 2019;13(2):1437-41. Halperin RO, Michael Gaziano J, Sesso HD. Smoking and the risk of incident hypertension in middle-aged and older men. American journal of hypertension. 2008;21(2):148–52. Justice AE, Winkler TW, Feitosa MF, Graff M, Fisher VA, Young K, et al. Genome-wide meta-analysis of 241,258 adults accounting for smoking behaviour identifies novel loci for obesity traits. Nature communications. 2017;8(1):14977. Kim Y-Y, Kang H-J, Ha S, Park JH. Interactions of behavioral changes in smoking, high-risk drinking, and weight gain in a population of 7.2 million in Korea. Journal of Preventive Medicine and Public Health. 2019;52(4):234. Cohen JB. Hypertension in obesity and the impact of weight loss. Current cardiology reports. 2017;19:1–8. Verberk WJ, Kessels AG, De Leeuw PW. Prevalence, causes, and consequences of masked hypertension: a meta-analysis. American journal of hypertension. 2008;21(9):969–75. Sung YJ, de Las Fuentes L, Winkler TW, Chasman DI, Bentley AR, Kraja AT, et al. A multi-ancestry genome-wide study incorporating gene–smoking interactions identifies multiple new loci for pulse pressure and mean arterial pressure. Human molecular genetics. 2019;28(15):2615–33. Additional Declarations No competing interests reported. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-4385327","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Article","associatedPublications":[],"authors":[{"id":312552121,"identity":"7affba23-3ba2-4acd-9119-4fe9186c2a6f","order_by":0,"name":"Seyedeh Mahdieh Namayandeh","email":"","orcid":"","institution":"Modeling in Health Research Center, Institute for Futures Studies in Health, Departments of Biostatistics and Epidemiology Shahid Sadoughi University of Medical Sciences, Yazd","correspondingAuthor":false,"prefix":"","firstName":"Seyedeh","middleName":"Mahdieh","lastName":"Namayandeh","suffix":""},{"id":312552122,"identity":"a30a6408-6a9f-44da-9140-1697a781ba17","order_by":1,"name":"Seyed hasan Emadi","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA9UlEQVRIiWNgGAWjYLACHoYDEMYHIGZjJ0UL4wyQFmZStDDzgEkCquXbewwfvGG4Iy/ff/jZY5tf2+T5mBkYP3zMwa3F4MwZY8M5DM8MN9xIMzfO7btt2MbMwCw5cxseLRI5ZtI8DIcZN0gwmEnn9txmBGphY+bFo0V+/hvz30At9vP7j3+Ttuy5bU9QC8MNHjOgrw8nNhwAWsfw43YiQS0GZ9KKJecYHE7ecCOnTLK34XZyGzNjM16/yLcf3vjhTcVhW6DDtkn8+HPbdn5788EPH/E5jIHDAGgXlM3YBiYb8KkHAvYHSJw/BBSPglEwCkbBiAQA+J9Q2b4xPJ0AAAAASUVORK5CYII=","orcid":"","institution":"Sadoughi University of Medical Sciences, Yazd,Iran","correspondingAuthor":true,"prefix":"","firstName":"Seyed","middleName":"hasan","lastName":"Emadi","suffix":""},{"id":312552123,"identity":"5d2f8974-f591-4ad0-a399-bbec3e511bb8","order_by":2,"name":"Fatemeh Majidpour","email":"","orcid":"","institution":"Modeling in Health Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman","correspondingAuthor":false,"prefix":"","firstName":"Fatemeh","middleName":"","lastName":"Majidpour","suffix":""},{"id":312552124,"identity":"34af4e7d-be43-4c95-97d7-a74793266bf4","order_by":3,"name":"Seyed Mahmood Sadr Bafghi","email":"","orcid":"","institution":"Yazd Cardiovascular Research Center, Non-communicable Diseases Research Institute, Shahid Sadoughi University of Medical Sciences, Yazd","correspondingAuthor":false,"prefix":"","firstName":"Seyed","middleName":"Mahmood Sadr","lastName":"Bafghi","suffix":""},{"id":312552127,"identity":"c2c7adce-ea6f-4ff4-9122-6654d792e263","order_by":4,"name":"Mohammadhosein Soltani","email":"","orcid":"","institution":"Yazd Cardiovascular Research Center, Non-communicable Diseases Research Institute, Shahid Sadoughi University of Medical Sciences, Yazd","correspondingAuthor":false,"prefix":"","firstName":"Mohammadhosein","middleName":"","lastName":"Soltani","suffix":""}],"badges":[],"createdAt":"2024-05-07 21:16:09","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-4385327/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-4385327/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":58316367,"identity":"07c83d11-1844-4d14-a053-c93bd6a998e9","added_by":"auto","created_at":"2024-06-13 21:07:43","extension":"jpeg","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":444983,"visible":true,"origin":"","legend":"\u003cp\u003eFlowchart Chart of participants Male \u0026nbsp;in Yazd Healthy Heart Cohort Study\u003c/p\u003e","description":"","filename":"floatimage1.jpeg","url":"https://assets-eu.researchsquare.com/files/rs-4385327/v1/9b50b596a0ace8af4747bbbb.jpeg"},{"id":58316365,"identity":"beca50a8-c664-445c-9129-bbcffcd2cd8b","added_by":"auto","created_at":"2024-06-13 21:07:43","extension":"jpeg","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":100690,"visible":true,"origin":"","legend":"\u003cp\u003eFlowchart Chart of 10-Years Hypertension Incidence According Smoke Status in Males at Baseline In participants in Yazd Healthy Heart Cohort Study\u003c/p\u003e","description":"","filename":"floatimage2.jpeg","url":"https://assets-eu.researchsquare.com/files/rs-4385327/v1/907e9ce794a967dbba581538.jpeg"},{"id":68162838,"identity":"bedd79b3-6e39-4c36-9e86-9449101cba39","added_by":"auto","created_at":"2024-11-04 09:17:39","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1173878,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-4385327/v1/6f653973-d214-476e-ba8e-0e225d7e5b58.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"A Prospective Study of Cigarette Smoking and Risk of 10-Years Incidence of Hypertension in men aged 20-74 years old; Yazd Healthy Heart Cohort Study (YHHC)","fulltext":[{"header":"Introduction","content":"\u003cp\u003eThe effects of cigarette smoking on blood pressure are complex, with evidence that smoking increases acute increase in blood pressure (BP), heart rate, risk of renovascular, malignant, and masked hypertension(\u003cspan additionalcitationids=\"CR2 CR3 CR4\" citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e).Hypertension is a major risk factor for cardiovascular diseases(\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e), heart failure(\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e), and end-stage renal disease. It is attributed to environmental factors such as stress, obesity, physical inactivity, and heavy salt consumption(\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eAmong these factors, cigarette smoking is an important lifestyle factor and is the most readily preventable risk factor for human death. It has detrimental effects on the health of both smokers and nonsmokers who are exposed to passive tobacco inhalation in the environment. Cigarette smoking is a strong risk factor for atherosclerosis and myocardial infarction because it increases platelet aggregation, decreases myocardial oxygen supply, increases oxygen demand, and decreases the threshold for ventricular fibrillation(\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e, \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e). It also increases the risk of cancers of the esophagus, pancreas, bladder, kidney, cervix, and bone marrow, with 90% of individuals who have lung cancer being smokers(\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e). Tobacco smoking temporarily increases blood pressure(\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e, \u003cspan additionalcitationids=\"CR11\" citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e), but the association between chronic smoking and hypertension according to the results of previous studies is controversial. Most of the previous studies are cross-sectional(\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e, \u003cspan additionalcitationids=\"CR14 CR15 CR16 CR17\" citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e) and could not confirm the causal relationship between smoking and hypertension incidence. Additionally, several studies that have assessed this relationship longitudinally have produced inconsistent results(\u003cspan additionalcitationids=\"CR20 CR21 CR22 CR23 CR24 CR25\" citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e) The aim of this sub-study of YHHC was to assess the relationship between smoking and hypertension incidence in a 10-year follow-up study in Yazd, Iran.\u003c/p\u003e"},{"header":"Methods","content":"\u003cp\u003eThe present study is a sub-study of the Yazd Healthy Heart Cohort (YHHC) project. The Yazd Healthy Heart Study is a ten-year cohort study conducted in two phases. In the first phase(\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e), 2000 participants aged 20\u0026ndash;74 years in the city of Yazd were enrolled in the study during 2004\u0026ndash;2005 and were followed up every year from 2009 to 2010. All demographic characteristics, lifestyle, cardiovascular risk factors, clinical cardiovascular disease, and mortality were collected and recorded by a questionnaire along with medical examinations. Subjects in the second phase were recruited again after ten years during 2014\u0026ndash;2015 and were evaluated for the above-mentioned factors. In this analysis, people aged 20\u0026ndash;74 years, living in the city of Yazd for at least one year in the first phase of YHHC, were included in the study, while all those who had hypertension or took medicine for hypertension in the first phase of YHHC, and all women, were excluded. A total of 848 individuals were hypertensive oadministered medicine at baseline and 1002 women were excluded from the study. Then this study was conducted on 571 normotensive men subjects during the ten-year follow-up period and 35 case didn't report their smoke status at baseline. Of the total 571 men, 125 (21.9%) were lost to follow-up. The lost to follow-up patients only visited at baseline. In total, the data of 446 men were follow- uped during 10 years were analyzed(Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e- Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e2\u003c/span\u003e,\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e3\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eAssociation between Participant'S Characteries at baseline and 10- years hypertension\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"6\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariable\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eTotal(n\u0026thinsp;=\u0026thinsp;446)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNormotensive (n\u0026thinsp;=\u0026thinsp;288)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eHypertension (n\u0026thinsp;=\u0026thinsp;158)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eCrude OR(95% CI)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eP-Value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge at baseline, years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e43.04\u0026thinsp;\u0026plusmn;\u0026thinsp;14.04\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e39.87\u0026thinsp;\u0026plusmn;\u0026thinsp;13.65\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e48.81\u0026thinsp;\u0026plusmn;\u0026thinsp;12.87\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.05(1.03\u0026ndash;1.07)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e**\u0026lt;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBMI\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e24.32\u0026thinsp;\u0026plusmn;\u0026thinsp;3.65\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e23.69\u0026thinsp;\u0026plusmn;\u0026thinsp;3.68\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e25.48\u0026thinsp;\u0026plusmn;\u0026thinsp;3.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.15(1.08\u0026ndash;1.22)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e**\u0026lt;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWaist\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e90.46\u0026thinsp;\u0026plusmn;\u0026thinsp;10.98\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e88.41\u0026thinsp;\u0026plusmn;\u0026thinsp;10.81\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e94.21\u0026thinsp;\u0026plusmn;\u0026thinsp;10.31\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.052(1.03\u0026ndash;1.07)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e**\u0026lt;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSBP, mmHg\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e120.6\u0026thinsp;\u0026plusmn;\u0026thinsp;8.58\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e118.7\u0026thinsp;\u0026plusmn;\u0026thinsp;8.44\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e124.05\u0026thinsp;\u0026plusmn;\u0026thinsp;7.75\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.089(1.06\u0026ndash;1.12)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e**\u0026lt;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDBP, mmHg\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e78.4\u0026thinsp;\u0026plusmn;\u0026thinsp;5.14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e77.81\u0026thinsp;\u0026plusmn;\u0026thinsp;5.17\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e79.49\u0026thinsp;\u0026plusmn;\u0026thinsp;4.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.072(1.02\u0026ndash;1.11)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e** 0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFBS\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e95.67\u0026thinsp;\u0026plusmn;\u0026thinsp;36.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e90.22\u0026thinsp;\u0026plusmn;\u0026thinsp;26.39\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e105.58\u0026thinsp;\u0026plusmn;\u0026thinsp;47.57\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.012(1.006\u0026ndash;1.01)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e**\u0026lt;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTriglycerides, mg/dl\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e168.13\u0026thinsp;\u0026plusmn;\u0026thinsp;107.08\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e156.12\u0026thinsp;\u0026plusmn;\u0026thinsp;100.66\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e189.96\u0026thinsp;\u0026plusmn;\u0026thinsp;114.99\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.003(1.001\u0026ndash;1.005)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e**0.002\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTotal cholesterol, mg/dl\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e187.67\u0026thinsp;\u0026plusmn;\u0026thinsp;41.12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e183.2\u0026thinsp;\u0026plusmn;\u0026thinsp;40.82\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e195.81\u0026thinsp;\u0026plusmn;\u0026thinsp;40.53\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.008(1.003\u0026ndash;1.01)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e**0.002\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHDL cholesterol, mg/dl\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e52.15\u0026thinsp;\u0026plusmn;\u0026thinsp;12.95\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e52.71\u0026thinsp;\u0026plusmn;\u0026thinsp;12.96\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e51.13\u0026thinsp;\u0026plusmn;\u0026thinsp;12.91\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.99(0.97\u0026ndash;1.006)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e**0.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLDL cholesterol, mg/dl\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e101.55\u0026thinsp;\u0026plusmn;\u0026thinsp;35.51\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e99.86\u0026thinsp;\u0026plusmn;\u0026thinsp;36.22\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e104.65\u0026thinsp;\u0026plusmn;\u0026thinsp;34.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.004(0.99\u0026ndash;1.009)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e*0.18\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUA\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4.72\u0026thinsp;\u0026plusmn;\u0026thinsp;1.14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4.76\u0026thinsp;\u0026plusmn;\u0026thinsp;1.12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e4.66\u0026thinsp;\u0026plusmn;\u0026thinsp;1.17\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.92(0.78\u0026ndash;1.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.36\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePhysical activity, %\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLow\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e227(64.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e136(59.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e91(40.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eRef\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eModerate\u0026thinsp;+\u0026thinsp;sever\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e126(35.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e86(68.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e40(31.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.69(0.44\u0026ndash;1.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e*0.12\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eParental History of Hypertension\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNon\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e281(63.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e183(65.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e98(34.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eRef\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMother\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e103(23.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e67(65)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e36(\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.003(0.62\u0026ndash;1.61)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.98\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFather\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e34(7.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e23(67.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e11(32.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.89(0.41\u0026ndash;1.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.77\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBoth\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e27(6.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e14(51.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e13(48.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.73(0.78\u0026ndash;3.83)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e*0.17\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSmoke status\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSmoker\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e116(27.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e79(68.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e37(31.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.81(0.51\u0026ndash;1.28)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNon- Smoker\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e303(72.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e192(63.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e111(36.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eRef\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.36\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c6\" namest=\"c1\"\u003e \u003cp\u003eBMI, body mass index; SBP, systolic blood pressure; HDL cholesterol, high-density lipoprotein cholesterol; LDL cholesterol, low-density lipoprotein cholesterol\u003c/p\u003e \u003cp\u003e**P\u0026thinsp;\u0026lt;\u0026thinsp;0.05, * 0.05\u0026thinsp;\u0026le;\u0026thinsp;P\u0026thinsp;\u0026lt;\u0026thinsp;0.2Univariate Logistic Regression, OR; Odds Ratio, CI; Confidence Interval\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003e Association between smoking status and hypertension by multivariate logistic regression models using backward stepwise algorithm\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariable\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNever smokers (n\u0026thinsp;=\u0026thinsp;376)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eCurrent Smoker(n\u0026thinsp;=\u0026thinsp;160)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eP-Value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTotal number of people with hypertension, %\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e111(36.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e37(31.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.36\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUnadjusted OR(95%CI)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.00(ref)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.81(0.51\u0026ndash;1.28)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.36\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMultivariate-adjusted\u003csup\u003ea\u003c/sup\u003e OR(95%CI)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.00(ref)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.52(0.29\u0026ndash;0.94)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e**0.032\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMultivariate-adjusted\u003csup\u003eb\u003c/sup\u003e OR(95%CI)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.00(ref)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.58(0.31\u0026ndash;1.08)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e*0.089\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"4\" nameend=\"c4\" namest=\"c1\"\u003e \u003cp\u003e\u003csup\u003ea\u003c/sup\u003e Adjusted for age, Parental History of hypertension, Waist, BMI, Physical activity, HDL, LDL, TG\u003c/p\u003e \u003cp\u003e\u003csup\u003eb\u003c/sup\u003e Adjusted age, SBP, DBP, TG, LDL, HDL, FBS, BMI, Waist, Parental History of hypertension, Physical activity\u003c/p\u003e \u003cp\u003e*P\u0026thinsp;\u0026lt;\u0026thinsp;0.1, **P\u0026thinsp;\u0026lt;\u0026thinsp;0.05, OR; Odds Ratio, CI; Confidence Interval\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eFigure \u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e\u003c/p\u003e \u003cp\u003eWe also observed that there were no statistically significant differences between the mean SBP, DBP, FBS, HDL, LDL, CHOL, age, and frequency of physical activity of the two groups, but there were statistically significant differences in the mean TG, body mass index, waist circumference, and frequency of parental history of hypertension between patients who were follow-uped and lost follow-up. We expected almost 30% of variables different between patients who were follow-uped and lost follow-up. Also, we adjusted the variables TG, body mass index, waist circumference, and parental history of hypertensionin the logistic regression model.\u003c/p\u003e \u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eEvaluating the Incidence of Hypertension\u003c/h2\u003e \u003cp\u003eAccording to the JNC7 Guideline, hypertension is defined as a systolic blood pressure\u0026thinsp;\u0026ge;\u0026thinsp;140, or a diastolic blood pressure\u0026thinsp;\u0026ge;\u0026thinsp;90, or taking antihypertensive drugs(\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e). We measured the blood pressure of our participants using a mercury sphygmomanometer in phase one and a digital sphygmomanometer, Omron Model, Japan in recent years(\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e, \u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e, \u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e).\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec4\" class=\"Section2\"\u003e \u003ch2\u003eHistory of traditional risk factors\u003c/h2\u003e \u003cp\u003eIndividuals who were taking anti-diabetic medications or had blood glucose levels above 126 mg/dL were classified as diabetic. Obesity was determined by a body mass index of 30 or higher. Family history of hypertension was categorized as having healthy first-degree relatives, a history of hypertension in one parent, or a history of hypertension in both parents based on self-reporting by participants. Cigarette smoking was defined as consuming ten or more cigarettes in the last three months at the time of study inclusion. Gender and age variables were also recorded based on individuals' phenotype and age at the time of study enrollment. Lipid profile was measured using a photometric method by a calorimetry enzyme device (CHOD-PAP)(\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e).\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec5\" class=\"Section2\"\u003e \u003ch2\u003eData Analysis\u003c/h2\u003e \u003cp\u003eDemographic and clinical characteristics of participants at baseline were reported using descriptive statistics. Independent t-tests and chi-square tests were used for univariate analysis to investigate significant differences in risk factors between male smokers and non-smokers. A graph illustrating the 10-year incidence of high blood pressure based on smoking status in men was created using Excel software. We employed a multivariable logistic regression model with the \"backward\" method to assess the risk of hypertension associated with smoking status while adjusting for other risk factors. All variables with a P-value less than 0.2 were included in the model. The level of statistical significance was set at 5% for final model and the analysis was conducted using SPSS software version 26.\u003c/p\u003e \u003c/div\u003e"},{"header":"Results","content":"\u003cp\u003eOut of a total of 446 male participants without hypertension at the beginning of the study, 29.9% (160) were smokers. After ten years, 37 men (31.9%) developed hypertension (Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e1\u003c/span\u003e- Fig.\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eCharacteristics of the study population according to smoking status at the baseline\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariable\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eTotal(n\u0026thinsp;=\u0026thinsp;517)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNever smokers (n\u0026thinsp;=\u0026thinsp;376)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eCurrent Smoker(n\u0026thinsp;=\u0026thinsp;160)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eP-Value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge at baseline, years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e43.14\u0026thinsp;\u0026plusmn;\u0026thinsp;14.56\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e42.05\u0026thinsp;\u0026plusmn;\u0026thinsp;15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e45.71\u0026thinsp;\u0026plusmn;\u0026thinsp;13.17\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e*0.008\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePhysical activity, %\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLow\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e273(64.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e183(60.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e90(74.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eModerate\u0026thinsp;+\u0026thinsp;sever\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e152(35.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e121(39.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e31(25.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e**0.006\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBMI, kg/m2 *\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e24.10\u0026thinsp;\u0026plusmn;\u0026thinsp;3.74\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e24.32\u0026thinsp;\u0026plusmn;\u0026thinsp;3.73\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e23.6\u0026thinsp;\u0026plusmn;\u0026thinsp;3.72\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e*0.044\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBMI, %\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLean or healthy\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e322(60.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e217(58.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e105(65.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOverweight\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e175(\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e128(34.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e47(29.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eObesity\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e34(6.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e26(\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e8(\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.28\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eParental History of Hypertension\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNon\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e371(69.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e268(71.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e103(65.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMother\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e98(18.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e60(16.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e38(24.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFather\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e34(6.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e24(6.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e10(6.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBoth\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e28(5.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e21(5.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e7(4.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.18\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWaist\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e89.79\u0026thinsp;\u0026plusmn;\u0026thinsp;11.33\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e90.1\u0026thinsp;\u0026plusmn;\u0026thinsp;11.26\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e89.08\u0026thinsp;\u0026plusmn;\u0026thinsp;11.50\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.34\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSBP, mmHg\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e120.42\u0026thinsp;\u0026plusmn;\u0026thinsp;8.52\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e120.84\u0026thinsp;\u0026plusmn;\u0026thinsp;8.35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e119.45\u0026thinsp;\u0026plusmn;\u0026thinsp;8.89\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.085\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDBP, mmHg\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e78.35\u0026thinsp;\u0026plusmn;\u0026thinsp;5.25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e78.71\u0026thinsp;\u0026plusmn;\u0026thinsp;5.06\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e77.5\u0026thinsp;\u0026plusmn;\u0026thinsp;5.57\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e*0.014\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFBS\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e95.15\u0026thinsp;\u0026plusmn;\u0026thinsp;35.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e92.36\u0026thinsp;\u0026plusmn;\u0026thinsp;29.89\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e96.34\u0026thinsp;\u0026plusmn;\u0026thinsp;37.88\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.23\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHistory of diabetes,(Yes) %\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e63(11.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e45(\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e18(11.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.81\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTriglycerides, mg/dl\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e161.51\u0026thinsp;\u0026plusmn;\u0026thinsp;103.22\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e164.16\u0026thinsp;\u0026plusmn;\u0026thinsp;107.28\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e155.28\u0026thinsp;\u0026plusmn;\u0026thinsp;92.99\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.36\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTotal cholesterol, mg/dl\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e186.04\u0026thinsp;\u0026plusmn;\u0026thinsp;41.23\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e186.13\u0026thinsp;\u0026plusmn;\u0026thinsp;41.47\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e185.84\u0026thinsp;\u0026plusmn;\u0026thinsp;40.79\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.94\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHDL cholesterol, mg/dl\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e52.43\u0026thinsp;\u0026plusmn;\u0026thinsp;12.82\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e50.20\u0026thinsp;\u0026plusmn;\u0026thinsp;12.57\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e50.63\u0026thinsp;\u0026plusmn;\u0026thinsp;13.27\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e*0.03\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLDL cholesterol, mg/dl\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e100.71\u0026thinsp;\u0026plusmn;\u0026thinsp;35.31\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e98.9\u0026thinsp;\u0026plusmn;\u0026thinsp;33.69\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e104.98\u0026thinsp;\u0026plusmn;\u0026thinsp;38.68\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.07\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"5\" nameend=\"c5\" namest=\"c1\"\u003e \u003cp\u003eBMI, body mass index; SBP, systolic blood pressure; HDL cholesterol, high-density lipoprotein cholesterol; LDL cholesterol, low-density lipoprotein cholesterol\u003c/p\u003e \u003cp\u003eP\u0026thinsp;\u0026lt;\u0026thinsp;0.05, * T-test Independent, **Chi-Square test\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003eFigure\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003e.\u003c/p\u003e \u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e1\u003c/span\u003e\u003c/p\u003e \u003cp\u003eThe Mean age of men at the beginning of the study was 43.14\u0026thinsp;\u0026plusmn;\u0026thinsp;14.56, and smoking men were on average 2 years older than non-smokers (P\u0026thinsp;=\u0026thinsp;0.008). The average body mass index of smoking men was statistically significantly lower than that of non-smokers (P\u0026thinsp;=\u0026thinsp;0.044). Additionally, the average waist circumference of smoking men was lower than that of non-smokers, but this difference was not statistically significant. The mean systolic and diastolic blood pressure, triglyceride, and total cholesterol were lower in smoking men compared to non-smokers. The levels of HDL and LDL were higher in smoking men, and the only statistically significant differences were in mean diastolic blood pressure and HDL between smoking and non-smoking men.From a total of 160 smoking men at the beginning of the study, 64.2% had low physical activity, 29.4% were overweight, and 5% were obese. 11.3% reported a history of diabetes, and most of the smoking men had a history of diabetes. Additionally, smoking men had less physical activity than non-smokers (P\u0026thinsp;=\u0026thinsp;0.006). 5.6% of non-smoking men and 4.4% of smoking men reported that both their parents had a history of hypertension (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e2\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e2\u003c/span\u003e.\u003c/p\u003e \u003cp\u003eThe results of univariate logistic regression showed that the variables measured at baseline, including age, body mass index, waist circumference, systolic blood pressure, diastolic blood pressure, blood sugar, triglycerides, and total cholesterol, were significantly related to the incidence of hypertension at a 5% significance level.\u003c/p\u003e \u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e3\u003c/span\u003e.\u003c/p\u003e \u003cp\u003eIn Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e3\u003c/span\u003e, participant non-smokers were used as controls. The adjusted odds ratio (OR) indicated that the occurrence of hypertension was lower in smokers compared to non-smokers in all models. Here, we conducted two logistic regression models to explore the impact of smoking on the likelihood of developing high blood pressure. In model 1, we analyzed the influence of smoking while adjusting for variables related to follow-up and loss of follow-up. In model 2, we investigated the relationship between smoking and the occurrence of hypertension while adjusting for variables that could affect hypertension (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e2\u003c/span\u003e). The OR ranged from 0.81 in the unadjusted model to 0.52 in the adjusted multivariable model. This decrease in the incidence of high blood pressure was significant in model a and in model B where it was significant at the 10% level(Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e3\u003c/span\u003e).\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eMultivariate logistic regression with backward LR models revealed significant Negative correlation between smoking and hypertension incidence in our 10 year follow-up study. Consistent with our findings ,Several longitudinal studies have evaluated this relationship. Some studies reported negative correlation for example a longitudinal study on 74,743 Korean adults with a mean 29 month follow up reported that cotinine-verified new smokers and sustained smokers had a lower risk for incident hypertension, especially men smokers, compared with non-smokers(\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e) also a longitudinal study with 2,427 Turkish adults showed current smoking is inversely associated with hypertension incidence by reducing waist circumference specially in women(\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e) But sohn(\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e) and our study reported no effect of weight in the in correlation between smoking and hypertension. Although the effect of smoking on BMI or body weight is inconsistent(\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e, \u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e, \u003cspan additionalcitationids=\"CR33\" citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e) obesity is an important risk factor of hypertension incidence in the literature(\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e, \u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e) and in our study.\u003c/p\u003e \u003cp\u003eSome studies showed positive correlation between smoking and incident hypertension. A longitudinal study in male Japanese workers with 14-year follow-up reported positive relationship between smoking and onset of hypertension by pooled logistic regression analysis(\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e). A longitudinal study with 28,577 males from a Chinese longitudinal survey with a long follow-up period assess this correlation with two independent variables in three age categories; current number of cigarettes smoked per day(CCS) that obtained from the questionnaire and life-course-adjusted number of cigarettes smoked per day(LCS) calculated by dividing the total number of cigarettes smoked by the survival time from birth. There was no significant association between smoking and hypertension incidence in the age category lower than 35. In age categories higher than 35 smoking increases the risk of hypertension incidence with respect to LCS and the risk increased with age but when they considered CCS, smoking reduced the risk of incident hypertension. LCS indicated the smoking status more real and reasonable. By comparison between LCS and CCS, this study explained why some studies reported smoking reduces the risk of incident hypertension. So we should consider the effects of smoking on human health over the long time and from a life-course perspective(\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eSome studies reported no significant correlation. Sohn reported no relation of smoking to hypertension in a large number of Indonesian men by fixed-effect models and panel data analysis with a long follow-up period(\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e). A large Mendelian randomization meta-analysis reported that smoking exposure in ever smokers increased resting heart rate but it didn\u0026rsquo;t have significant association with SBP, DBP and hypertension. This meta-analysis performed according to the genetic variant rs16969968/rs1051730 as a strong indicator of smoking heaviness but this genetic variant isn\u0026rsquo;t associated with smoking status and just assessed in ever smokers. This study suggested that there may not be a strong association between smoking and blood pressure and more attention should be paid to resting heart rate as a predictor of heart events. Also several studies have shown resting hear rate as an independent cardiovascular risk factor even after adjusting other risk factors such as blood pressure(\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eSome mechanisms explain the effect of smoking on hypertension. Tobacco smoking causes metabolic dysregulation, increases mitochondrial oxidative stress, reduces endothelial NO, impairs endothelial-dependent relaxation leading to endothelial dysfunction and development of hypertension (\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e) also nicotine stimulates release of catecholamines from sympathetic nervous system and causes acute increase in inotrope effect, heart rate and blood pressure. But Nicotine has biphasic action on sympathetic neurons; Ganglionic stimulation followed by depressant effect(\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e). Also some studies reported the tolerance to nicotine effect(\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e). Chance of exposure to smoking in masked hypertensives is more often than normotensives (mean difference 18%; P\u0026thinsp;\u0026lt;\u0026thinsp;0.03). therefore, masked hypertension occurs more in smokers(\u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e). Both Smoking and hypertension are associated with genetic differences. Multiple loci are identified that have a role in blood pressure regulation and some of these loci have significant interaction with smoking status. So there may be genetic association between smoking and blood pressure(\u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e).\u003c/p\u003e"},{"header":"Conclusions","content":"\u003cp\u003eA history of cigarette smoking does not increase the incidence of hypertension over a 10-year period. However, smoking is a major risk factor for cardiovascular diseases. Smokers should not be complacent because smoking can still affect metabolic risk factors such as hypertension, ultimately increasing the risk of cardiovascular disease.\u003c/p\u003e \u003cdiv id=\"Sec9\" class=\"Section2\"\u003e \u003ch2\u003eStudy limitations:\u003c/h2\u003e \u003cp\u003eOne important limitation of our study is that we only analyzed two sets of data (at baseline and at the end of the 10-year follow-up period). We did not take into account changes in smoking status during the middle years of the study, so changes in smoking habits were not considered. Additionally, we did not analyze smoking quantitatively based on smoking duration and pack-years, which prevented us from discussing the dose-response effect of smoking on blood pressure over time. Additionally, women were not included in this study. The rate of smoking reported among the women in this study was very low, and the occurrence of hypertension in women who smoked was so minimal, which skewed the analysis results. It appears that women may have underreported smoking due to social stigmas.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec10\" class=\"Section2\"\u003e \u003ch2\u003eSuggestions:\u003c/h2\u003e \u003cp\u003eWe recommend studying cohorts of smokers while considering both qualitative and quantitative aspects of smoking, as well as genetic variations within the population. Furthermore, it would be beneficial to measure various outcomes that may result from smoking.\u003c/p\u003e \u003c/div\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eConflict of interest\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors have no conflicts of interest to declare for this study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eStatement\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis manuscript is original, has not been published before, and is not under consideration for\u0026nbsp;\u0026lrm;publication anywhere.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgements\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis work was supported by\u0026nbsp;Modeling in Health Research Center, Institute for Futures Studies in Health, Departments of Biostatistics and Epidemiology Shahid Sadoughi University of Medical Sciences, Yazd\u003cstrong\u003e.\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026rsquo; contributions:\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eSM.N Conceptualization, Collecting data, Critical revision, methodology, Analysis of data, SH.E wrote the main manuscript text, Critical revision, F.M Participate in writting the main manuscript text, Collecting data, Analysis of data, SM.S and MH.S Critical revision, All authors reviewed the manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding:\u003c/strong\u003e This work was supported by Shahid Sadoughi University of Medical sciences Yazd, Iran.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting Interests\u003c/strong\u003e: The authors declare that they have no competing interests\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003ePatient and public involvement\u003c/strong\u003e: Patients and/or the public were not involved in design, plan, manage and carry out research.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe present study was ethically approved by the ShahidSadoughi University of Medical Sciences\u0026rsquo; ethics committee (ethics code: IR.SSU.SPH.REC.1400.052). All provisions of the Declaration of Helsinki adhered in our study, especially appropriate ethical and scientific review. The study is a sub-study of the YHHC cohort study. Informed consent was obtained from each patient at the beginning of this study. All patients signed a predefined consent form, specifically allowing for the usage of their clinical data.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of Data and Materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe data that support the findings of this study are available from [Dr\u0026nbsp;\u003cstrong\u003e\u003cem\u003eSeyedeh \u0026nbsp;Mahdieh Namayandeh\u003c/em\u003e\u003c/strong\u003e] but restrictions apply to the availability of these data, which were used under license for the current study, and so are not publicly available. Data are however available from the authors upon reasonable request and with permission of [Dr\u0026nbsp;\u003cstrong\u003e\u003cem\u003eSeyedeh \u0026nbsp; Mahdieh Namayandeh\u003c/em\u003e\u003c/strong\u003e].\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003ePrimatesta P, Falaschetti E, Gupta S, Marmot MG, Poulter NR. Association between smoking and blood pressure: evidence from the health survey for England. Hypertension. 2001;37(2):187\u0026ndash;93.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003ePeralta CA, Norris KC, Li S, Chang TI, Tamura MK, Jolly SE, et al. Blood pressure components and end-stage renal disease in persons with chronic kidney disease: the Kidney Early Evaluation Program (KEEP). Archives of internal medicine. 2012;172(1):41\u0026ndash;7.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eRhee M-Y, Na S-H, Kim Y-K, Lee M-M, Kim H-Y. Acute effects of cigarette smoking on arterial stiffness and blood pressure in male smokers with hypertension. American journal of hypertension. 2007;20(6):637\u0026ndash;41.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eVirdis A, Giannarelli C, Fritsch Neves M, Taddei S, Ghiadoni L. Cigarette smoking and hypertension. Current pharmaceutical design. 2010;16(23):2518\u0026ndash;25.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003emohammed Ali W. What's New in Cigarette Smoking and Hypertension? Kirkuk Journal of Medical Sciences. 2024;12(1).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eStanaway JD, Afshin A, Gakidou E, Lim SS, Abate D, Abate KH, et al. Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks for 195 countries and territories, 1990\u0026ndash;2017: a systematic analysis for the Global Burden of Disease Study 2017. The Lancet. 2018;392(10159):1923\u0026ndash;94.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKannan A, Janardhanan R. Hypertension as a risk factor for heart failure. Current hypertension reports. 2014;16:1\u0026ndash;8.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKumar V, Abbas A, Aster J. Robbins and cotran pathologic basis of disease ninth edition. Amsterdam, Netherlands; 2015.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003ePankova A, Kralikova E, Fraser K, Lajka J, Svacina S, Matoulek M. No difference in hypertension prevalence in smokers, former smokers and non-smokers after adjusting for body mass index and age: a cross-sectional study from the Czech Republic, 2010. Tobacco induced diseases. 2015;13:1\u0026ndash;7.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eGeneral USPHSOotS. How tobacco smoke causes disease: the biology and behavioral basis for smoking-attributable disease: a report of the Surgeon General: US Department of Health and Human Services, Public Health Service, Office of \u0026hellip;\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eDimitriadis K, Tsioufis K, Konstantinidis D, Kalos T, Fragoulis C, Konstantinou K, et al. ACUTE DETRIMENTAL EFFECTS OF E-CIGARETTE AND TOBACCO CIGARETTE SMOKING ON BLOOD PRESSURE AND SYMPATHETIC NERVE ACTIVITY IN HEALTHY SUBJECTS. Journal of Hypertension. 2018;36:e245.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLeone A. Smoking and hypertension: independent or additive effects to determining vascular damage? Current vascular pharmacology. 2011;9(5):585\u0026ndash;93.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKim SH, Lee JS. The association of smoking and hypertension according to cotinine-verified smoking status in 25,150 Korean adults. Clinical and experimental hypertension. 2019;41(5):401\u0026ndash;8.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKim BJ, Han JM, Kang JG, Kim BS, Kang JH. Association between cotinine-verified smoking status and hypertension in 167,868 Korean adults. Blood Pressure. 2017;26(5):303\u0026ndash;10.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMehboudi M, Nabipour I, Vahdat K, Darabi H, Raeisi A, Mehrdad N, et al. Inverse association between cigarette and water pipe smoking and hypertension in an elderly population in Iran: Bushehr elderly health programme. Journal of human hypertension. 2017;31(12):821\u0026ndash;5.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLi G, Wang H, Wang K, Wang W, Dong F, Qian Y, et al. The association between smoking and blood pressure in men: a cross-sectional study. BMC Public Health. 2017;17:1\u0026ndash;6.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAlomari MA, Al-Sheyab NA. Cigarette smoking lowers blood pressure in adolescents: the Irbid-TRY. Inhalation Toxicology. 2016;28(3):140\u0026ndash;4.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eOkubo Y, Miyamoto T, Suwazono Y, Kobayashi E, Nogawa K. An association between smoking habits and blood pressure in normotensive Japanese men. Journal of human hypertension. 2002;16(2):91\u0026ndash;6.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKim BJ, Seo DC, Kim BS, Kang JH. Relationship between cotinine-verified smoking status and incidence of hypertension in 74,743 Korean adults. Circulation Journal. 2018;82(6):1659\u0026ndash;65.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSohn K. Relationship of smoking to hypertension in a developing country. Global heart. 2018;13(4):285\u0026ndash;92.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eGao K, Shi X, Wang W. The life-course impact of smoking on hypertension, myocardial infarction and respiratory diseases. Scientific reports. 2017;7(1):4330.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLinneberg A, Jacobsen RK, Skaaby T, Taylor AE, Fluharty ME, Jeppesen JL, et al. Effect of smoking on blood pressure and resting heart rate: a Mendelian randomization meta-analysis in the CARTA consortium. Circulation: Cardiovascular Genetics. 2015;8(6):832\u0026ndash;41.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKaneko M, Oda E, Kayamori H, Nagao S, Watanabe H, Abe T, et al. Smoking was a possible negative predictor of incident hypertension after a five-year follow-up among a general Japanese population. Cardiology Research. 2012;3(2):87.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eDochi M, Sakata K, Oishi M, Tanaka K, Kobayashi E, Suwazono Y. Smoking as an independent risk factor for hypertension: a 14-year longitudinal study in male Japanese workers. The Tohoku journal of experimental medicine. 2009;217(1):37\u0026ndash;43.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKadonaga Y, Dochi M, Sakata K, Oishi M, Tanaka K, Morimoto H, et al. Longitudinal evaluation of the effect of smoking initiation on body weight, blood pressure, and blood biochemistry. Preventive medicine. 2009;48(6):567\u0026ndash;71.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eOnat A, Uğur M, Hergen\u0026ccedil; G, Can G, Ordu S, Dursunoğlu D. Lifestyle and metabolic determinants of incident hypertension, with special reference to cigarette smoking: a longitudinal population-based study. American journal of hypertension. 2009;22(2):156\u0026ndash;62.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eNamayandeh SM, Sadr S, Ansari Z, Rafiei M. A cross-sectional study of the prevalence of coronary artery disease traditional risk factors in Yazd urban population, Yazd healthy heart project. 2011.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eWhelton PK, Carey RM, Aronow WS, Casey DE, Collins KJ, Himmelfarb CD, et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Journal of the American College of Cardiology. 2018;71(19):e127-e248.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAbbas R, Mahdieh N, Abdoreza R, Hamidreza T, Mahmood S. Longitudinal Study of Blood Pressure during 8 Years; Patterns and Correlates: Yazd Healthy Heart Project. J Hypertens. 2016;5(215):2167-1095.1000215.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMohammadhoseini M, Namayandeh SM, Fallahzadeh H, Majidpour F, Sadr-Bafghi SM, Soltani M, et al. Population attributable risk of hyperuricemia in hypertension incidence in 20-74-year-old population during a 10-year longitudinal cohort: yazd healthy heart cohort. Iranian Journal of Public Health. 2020;49(10):1977.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eNamayandeh SM, Karimi A, Fallahzadeh H, Rahmanian M, Bafghi SMS, Soltani M, et al. The incidence rate of diabetes mellitus (type II) and its related risk factors: A 10-year longitudinal study of Yazd Healthy Heart Cohort (YHHC), Iran. Diabetes \u0026amp; Metabolic Syndrome: Clinical Research \u0026amp; Reviews. 2019;13(2):1437-41.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHalperin RO, Michael Gaziano J, Sesso HD. Smoking and the risk of incident hypertension in middle-aged and older men. American journal of hypertension. 2008;21(2):148\u0026ndash;52.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eJustice AE, Winkler TW, Feitosa MF, Graff M, Fisher VA, Young K, et al. Genome-wide meta-analysis of 241,258 adults accounting for smoking behaviour identifies novel loci for obesity traits. Nature communications. 2017;8(1):14977.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKim Y-Y, Kang H-J, Ha S, Park JH. Interactions of behavioral changes in smoking, high-risk drinking, and weight gain in a population of 7.2 million in Korea. Journal of Preventive Medicine and Public Health. 2019;52(4):234.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eCohen JB. Hypertension in obesity and the impact of weight loss. Current cardiology reports. 2017;19:1\u0026ndash;8.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eVerberk WJ, Kessels AG, De Leeuw PW. Prevalence, causes, and consequences of masked hypertension: a meta-analysis. American journal of hypertension. 2008;21(9):969\u0026ndash;75.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSung YJ, de Las Fuentes L, Winkler TW, Chasman DI, Bentley AR, Kraja AT, et al. A multi-ancestry genome-wide study incorporating gene\u0026ndash;smoking interactions identifies multiple new loci for pulse pressure and mean arterial pressure. Human molecular genetics. 2019;28(15):2615\u0026ndash;33.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"","lastPublishedDoi":"10.21203/rs.3.rs-4385327/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-4385327/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eThe effects of cigarette smoking on blood pressure are complex, with evidence that smoking increases acute increase in blood pressure (BP), heart rate, risk of renovascular, malignant, and masked hypertension. We evaluated smoking status in phase I and hypertension incidence in males after 10 years using YHHC (Yazd Healthy Heart Cohort Study) data. All of normotensives participants enrolled the analysis. Univariate analysis was performed via Chi -square and student T tes and we employed a multivariable logistic regression model with the \"backward\" method to assess the risk of hypertension associated with smoking status while adjusting for other risk factors. out of total 446 male follow \u0026ndash;uped during 10-years, 37 new case(31.9%) developed hypertension incidence in smoker men at the baseline. We found in Multivariate-adjusted\u003csup\u003ea\u003c/sup\u003e(aOR\u0026thinsp;=\u0026thinsp;0.52,95%CI(0.29\u0026ndash;0.94,P\u0026thinsp;=\u0026thinsp;0.032) and Multivariate-adjusted\u003csup\u003eb\u003c/sup\u003e(aOR\u0026thinsp;=\u0026thinsp;0.58,95%CI(0.31\u0026ndash;1.08,P\u0026thinsp;=\u0026thinsp;0.089) withStepwise Model selection variable Cigarette Smoking history don\u0026rsquo;t increase 10-years hypertension.we observed history of smoking associated with decrease hypertension incidence.\u003c/p\u003e","manuscriptTitle":"A Prospective Study of Cigarette Smoking and Risk of 10-Years Incidence of Hypertension in men aged 20-74 years old; Yazd Healthy Heart Cohort Study (YHHC)","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-06-13 21:07:39","doi":"10.21203/rs.3.rs-4385327/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"690d6332-22b0-4224-999f-40dab2e20431","owner":[],"postedDate":"June 13th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[{"id":33035344,"name":"Health sciences/Medical research/Epidemiology"},{"id":33035345,"name":"Health sciences/Medical research/Outcomes research"}],"tags":[],"updatedAt":"2024-11-04T09:09:23+00:00","versionOfRecord":[],"versionCreatedAt":"2024-06-13 21:07:39","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-4385327","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-4385327","identity":"rs-4385327","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}