The Combined Impact of Alcohol Consumption and Smoking Habits on Blood Pressure Control Among Hypertensive Adults: An Analysis of NHANES 2021-2023 Data
Department
Department of Epidemiology, Biostatistics and Environmental Health
Graduate Level
Master’s
Graduate Program/Concentration
Joint School of Public Health - Master's in Public Health, Concentration in Applied Data Science
Presentation Type
No Preference
Abstract
Background: Hypertension, a leading risk factor for cardiovascular disease, affects nearly half of U.S. adults. While lifestyle factors such as alcohol consumption and smoking are independently linked to hypertension, their combined impact on blood pressure control remains underexplored. This study investigates the individual and interactive effects of alcohol use and smoking habits on hypertension management.
Method: A cross-sectional analysis using the data from the 2021-2023 National Health and Nutrition Examination Survey (NHANES) was conducted on 3,756 hypertensive adults, categorizing participants by smoking status (current, former, never smokers) and alcohol consumption patterns (never, occasional, heavy drinkers). Hypertension was classified into Stage I (130-139/80-89 mmHg) and Stage II (≥140/90 mmHg). Logistic regression models adjusted for demographic, socioeconomic, and health-related covariates were employed to assess associations.
Results: Results revealed that heavy alcohol consumption was a robust predictor of both Stage I (OR = 1.481, 95% CI: 1.250–1.756) and Stage II hypertension (OR = 1.399, 95% CI: 1.126–1.737), even after adjustment for confounders. Smoking showed weaker associations, with current smokers exhibiting elevated odds of Stage I hypertension in unadjusted models (OR = 1.382, 95% CI: 1.121–1.704), which diminished after adjustment. The combined effects of heavy drinking and current smoking suggested a potential amplification of hypertension risk, though this interaction was not statistically significant. Notably, heavy drinkers and current smokers exhibited a higher prevalence of Stage II hypertension, emphasizing the compounded risk of these behaviors.
Conclusion: These findings underscore the critical role of heavy alcohol consumption in hypertension management and highlight the need for targeted interventions to reduce alcohol intake and promote smoking cessation. Clinicians should adopt a holistic approach to address multiple high-risk behaviors in hypertensive patients, as these behaviors may interact to exacerbate cardiovascular risk. Future research should explore longitudinal and mechanistic insights to better understand the interplay between smoking, alcohol use, and hypertension, particularly through biomarkers of inflammation and oxidative stress. Such insights are essential for developing tailored public health strategies and clinical guidelines to improve cardiovascular outcomes and enhance hypertension management in at-risk populations.
Keywords
Hypertension, Alcohol, Smoking, Heart Health, Cardiovascular Risk, NHANES, Public Health Data
The Combined Impact of Alcohol Consumption and Smoking Habits on Blood Pressure Control Among Hypertensive Adults: An Analysis of NHANES 2021-2023 Data
Background: Hypertension, a leading risk factor for cardiovascular disease, affects nearly half of U.S. adults. While lifestyle factors such as alcohol consumption and smoking are independently linked to hypertension, their combined impact on blood pressure control remains underexplored. This study investigates the individual and interactive effects of alcohol use and smoking habits on hypertension management.
Method: A cross-sectional analysis using the data from the 2021-2023 National Health and Nutrition Examination Survey (NHANES) was conducted on 3,756 hypertensive adults, categorizing participants by smoking status (current, former, never smokers) and alcohol consumption patterns (never, occasional, heavy drinkers). Hypertension was classified into Stage I (130-139/80-89 mmHg) and Stage II (≥140/90 mmHg). Logistic regression models adjusted for demographic, socioeconomic, and health-related covariates were employed to assess associations.
Results: Results revealed that heavy alcohol consumption was a robust predictor of both Stage I (OR = 1.481, 95% CI: 1.250–1.756) and Stage II hypertension (OR = 1.399, 95% CI: 1.126–1.737), even after adjustment for confounders. Smoking showed weaker associations, with current smokers exhibiting elevated odds of Stage I hypertension in unadjusted models (OR = 1.382, 95% CI: 1.121–1.704), which diminished after adjustment. The combined effects of heavy drinking and current smoking suggested a potential amplification of hypertension risk, though this interaction was not statistically significant. Notably, heavy drinkers and current smokers exhibited a higher prevalence of Stage II hypertension, emphasizing the compounded risk of these behaviors.
Conclusion: These findings underscore the critical role of heavy alcohol consumption in hypertension management and highlight the need for targeted interventions to reduce alcohol intake and promote smoking cessation. Clinicians should adopt a holistic approach to address multiple high-risk behaviors in hypertensive patients, as these behaviors may interact to exacerbate cardiovascular risk. Future research should explore longitudinal and mechanistic insights to better understand the interplay between smoking, alcohol use, and hypertension, particularly through biomarkers of inflammation and oxidative stress. Such insights are essential for developing tailored public health strategies and clinical guidelines to improve cardiovascular outcomes and enhance hypertension management in at-risk populations.