Key result
Tobacco use (OR 5.1; 95% CI 3.6-7.3) and alcohol consumption (OR 1.5; 95% CI 1.1-2.2) were strongly associated with hypertension, with population attributable risks of 70.3% and 33.6%.
Why the study?
What is the population attributable risk of tobacco use and alcohol consumption for hypertension in an Indian population?
Case-Control (n=700)
What is the population attributable risk of tobacco use and alcohol consumption for hypertension in an Indian population?
Tobacco use and alcohol consumption are major modifiable risk factors for hypertension in the Indian population, accounting for a large proportion of the population attributable risk.
Supports targeted prevention in Indian populations; leaves open causality and intervention effects pending prospective data.
BACKGROUND: Little evidence exists regarding the magnitude of contribution of risk factors associated with hypertension in India. Determination of potentially modifiable risk factors is necessary to focus prevention strategies. DESIGN: Age-matched case-control study. METHODS: A total of 350 hypertensive cases and 350 controls of both sexes in the age group 20-65 years. Hypertension was defined according to JNC VII criteria. Adjusted odds ratio (OR) and population attributable risk percentage (PAR %) for hypertension were calculated. RESULTS: In multivariate analysis, tobacco users (either tobacco chewing/smoking or both) (adjusted OR 5.1, 95% CI 3.6-7.3), tobacco chewing (adjusted OR 3.2, 95% CI 2.2-4.6), smoking (adjusted OR 2.9, 95% CI 1.9-4.4), and alcohol consumption (adjusted OR 1.5, 95% CI 1.1-2.2) was the strongest determinants of hypertension. A dose-response relation was found between the number of cigarettes smoked per day (χ2 for trend = 26.07; p < 0.0001) and the amount of alcohol consumption per day (χ2 for trend = 24.26; p < 0.0001) and the risk of hypertension. PARs were 70.3% (95% CI 63.0-77.5) for tobacco use, 45.3% (95% CI 37.1-53.4) for tobacco chewing, 31.5% (95% CI 21.3-40.9) for smoking, and 33.6% (95% CI 22.9-44.4) for alcohol consumption. CONCLUSION: Our results indicate that incident hypertension cases are largely attributable to the habit of tobacco use and alcohol consumption. Therefore, changing these selected lifestyle factors needs to be prioritized as a major strategy for reducing incidence of hypertension in our population.
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Shankarishan et al. (2012) conducted a case-control in hypertension (n=700). Tobacco use vs. Non-users was evaluated on hypertension (OR 5.1, 95% CI 3.6-7.3). Tobacco use (OR 5.1; 95% CI 3.6-7.3) and alcohol consumption (OR 1.5; 95% CI 1.1-2.2) were strongly associated with hypertension, with population attributable risks of 70.3% and 33.6%.
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