Secondhand smoke exposure and blood pressure in children and adolescents participating in the United States National Health and Nutrition Examination Survey, 2007-2012

Abstract

TPS 771: Diet and lifestyle, Exhibition Hall, Ground floor, August 26, 2019, 3:00 PM - 4:30 PM Background/Aim: To assess the relationship between acute and intermittent secondhand tobacco smoke (SHS) exposure with child and adolescent blood pressure (BP). Methods: We analyzed data from 3579 children and adolescents participating in the United States National Health and Nutrition Examination Survey (NHANES) between 2007 and 2012, with SHS exposure assessed via serum cotinine (biomarker for acute exposures) and urine NNAL (4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol, biomarker for intermittent exposures). BP measures were calculated as percentiles (adjusted for age, sex, height) according to the 2017 guidelines established by the American Academy of Pediatrics. We used weighted linear regression accounting for the complex sampling weights from NHANES and adjusting for socio-demographic and clinical characteristics. Results: Overall, participants were predominantly non-Hispanic white with a mean age of 12.6 years. There was approximately equal representation of boys and girls. Approximately 15.9% of participants lived in homes where smoking is present. In adjusted models, an interquartile range (IQR) increase in urinary NNAL was associated with a 2.93 (95% CI: 1.00-4.87) point increase in diastolic blood pressure (DBP) percentiles, and with a 2.76 (95% CI: 0.29-5.22) point increase in systolic blood pressure (SBP) percentiles. The association of NNAL and BP differed by sex. Among boys, an IQR increase in NNAL was associated with a 4.77 (95% CI: 2.50-7.06) point increase in DBP percentiles, but was not associated with SBP percentiles. Meanwhile, among girls, an IQR increase in NNAL was not associated with DBP percentiles, but was associated with a 4.30 (95% CI: 0.56-8.03) point increase in SBP percentiles. An IQR increase in serum cotinine was associated with a 2.73 (95% CI: 0.42-5.05) point increase in DBP percentiles, but was not associated with SBP percentiles. Conclusions: Our findings provide strong evidence for the relationship between acute and intermittent SHS and increased BP percentiles among children and adolescents in the United States.