Effect of passive exposure to cigarette smoke on blood pressure in children and adolescents: a meta-analysis of epidemiologic studies

Mahshid Aryanpur,Alireza Oraii,Hamidreza Jamaati,Hooman Sharifi,Mahmoud Yousefifard,Mehdi Kazempour-Dizaji,Gholamreza Heydari,Mostafa Hosseini

doi:10.1186/s12887-019-1506-7

Abstract

BackgroundHypertension is an emerging disease in children and adolescents resulting in future morbidities. Cigarette smoking is one of the most studied contributing factors in this regard; however, there are contradictory results among different studies. Therefore, the present meta-analysis tends to assess the relationship between passive exposure to cigarette smoke and blood pressure in children and adolescents.MethodMedline, Embase, Scopus, EBSCO, and Web of Sciences were systematically reviewed for observational studies up to May, 2017, in which the relationship between cigarette smoking and hypertension were assessed in children and adolescents. The meta-analysis was performed with a fixed effect or random effects model according to the heterogeneity.ResultsTwenty-nine studies were included in present meta-analysis incorporating 192,067 children and adolescents. Active smoking (pooled OR = 0.92; 95% CI: 0.79 to 1.05) or passive exposure to cigarette smoke (pooled OR = 1.01; 95% CI: 0.93 to 1.10) were not associated with developing hypertension in the study population. Despite the fact that active cigarette smoking did not significantly affect absolute level of systolic and diastolic blood pressure, it was shown that passive exposure to cigarette smoke leads to a significant increase in absolute level of systolic blood pressure (pooled coefficient = 0.26; 95% CI: 0.12 to 0.39).ConclusionBoth active and passive cigarette smoking were not associated with developing hypertension in children and adolescents. However, passive cigarette smoke was associated with higher level of systolic blood pressure in children and adolescents.

Highlights

Hypertension is an emerging disease in children and adolescents resulting in future morbidities
Despite the fact that active cigarette smoking did not significantly affect absolute level of systolic and diastolic blood pressure, it was shown that passive exposure to cigarette smoke leads to a significant increase in absolute level of systolic blood pressure
Fifteen studies evaluated the association between active smoking or passive exposure to cigarette smoke with hypertension [28,29,30,31,32,33,34,35,36,37,38,39,40,41,42] and 17 studies assessed the association between cigarette smoking and absolute levels of systolic and diastolic blood pressure [34, 41,42,43,44,45,46,47,48,49,50,51,52,53,54,55,56]

Summary

Introduction

Hypertension is an emerging disease in children and adolescents resulting in future morbidities. Aryanpur et al BMC Pediatrics (2019) 19:161 report that there is no association between cigarette smoking and hypertension in children [11] The importance of this issue is that both cigarette smoking and hypertension are two risk factors of non-communicable diseases [12, 13]. Presence of two risk factors in a single individual may lead to an additive or synergistic effect on incidence of chronic diseases. This issue must be more emphasized in childhood as most diseases of adulthood are consequences of childhood health status. The present meta-analysis was designed to assess the association between exposure to cigarette smoke and systolic and diastolic blood pressure in addition to its risk for incidence of hypertension in children and adolescents

Methods

Results

Discussion

Conclusion