Smoking-driven systemic inflammation elevates mortality risk in hypertensive patients: A cross-sectional study using...

Area of Science:

• Cardiovascular Disease Epidemiology
• Public Health Research
• Inflammation Biomarkers

Background:

• Conflicting evidence exists regarding smoking's association with hypertension (HTN).
• The role of systemic inflammation in smoking-related mortality among hypertensive patients is not well understood.
• This study investigates smoking, HTN risk, and the mediating role of systemic inflammation in mortality.

Purpose of the Study:

• To examine the association between smoking status, volume, and HTN risk.
• To determine if systemic inflammation (measured by SII) mediates smoking's link to all-cause mortality in hypertensive individuals.

Main Methods:

• Cross-sectional analysis of 28,967 participants from NHANES (1999-2018).
• Propensity score matching (PSM) adjusted for confounders.
• Logistic regression, restricted cubic spline, and mediation analyses were used.

Main Results:

• Smoking significantly increased HTN likelihood (AOR=1.18).
• A dose-response relationship was observed, with >30 cigarettes/day showing highest HTN risk (AOR=1.37).
• Smoking increased mortality in hypertensive patients (HR=1.993), with SII mediating 87.70% of this risk.

Conclusions:

• A significant association exists between smoking, HTN, and mortality.
• Systemic inflammation is a key mediator of increased mortality in hypertensive smokers.
• Interventions targeting smoking cessation and systemic inflammation are crucial for reducing HTN-related morbidity and mortality.