Abstract
Introduction: Hypertension is one of the leading cardiovascular risk factors, with a prevalence of almost 875 million individuals worldwide. Hypertension prevalence is higher among men than women until after menopause. No studies have determined a relationship between hypertension and the use of electronic cigarettes (E-Cig). This study sought to determine the relationship and sex differences in hypertension associated with tobacco and E-Cigarette use Methods: National Health Interview Survey Data from the years 2014, 2016, 2017, and 2018 were analyzed. Multivariate logistic regression analyses with Fisher’s Scoring iterative algorithm determined the covariate-adjusted and weighted odds ratios of clinical cardiovascular outcomes (i.e., hypertension) and their potential association with the use of tobacco or e-cigarettes by sex after controlling for age and body mass index (BMI). Results: A total of 121,705 participants completed the survey and met inclusion criteria, of which 66,762 were female users, and 54,943 were male users. Female e-cigarette users were 2.23 times more likely (95% CI:1.29 - 3.86, P < 0.05) to report hypertension than those who never used cigarettes or e-cigarettes. Female cigarette smokers were 1.63 times more likely (95% CI:1.32 - 2.01, P < 0.05), and male cigarette smokers were 1.34 times more likely (95% CI:1.12 -1.60, P < 0.05) to report hypertension than those who never used cigarettes or e-cigarettes. Female and male dual users (of E-Cig and tobacco) had similar odds of 1.40 (95% CI:1.08 -1.83, P < 0.05), and 1.41 (95% CI: 1.13 - 1.77, P < 0.05) to report hypertension than those who never smoked. Discussion: The findings from this study suggest that females reporting current e-cigarette use had the highest odds of reporting hypertension, followed by female tobacco smokers. Both male and female dual users had a similar risk of hypertension.
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