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Smoke-free policies linked to lower systolic BP
Smoke-free policies may contribute to reductions in systolic BP in nonsmoking adults, according to a study published in the Journal of the American Heart Association.
“We found that nonsmoking adults in the study who lived in areas with smoke-free laws in restaurants, bars or workplaces had lower systolic blood pressure by the end of the follow-up period compared to those who lived in areas without smoke-free laws,” Stephanie L. Mayne, PhD, research scientist at PolicyLab and the Center for Pediatric Clinical Effectiveness at Children’s Hospital of Philadelphia, said in a press release. “Also, when we looked at differences in blood pressure over time within individuals, comparing years when they lived in an area with a smoke-free law to years when they didn’t, systolic blood pressure was lower on average when they lived in an area with smoke-free laws, after accounting for overall trends in blood pressure and for how people’s levels of risk factors like diet and physical activity changed over the study period.”
To examine the association between smoke-free legislation and BP, researchers analyzed longitudinal data from 2,606 nonsmoking adults who were participants in the CARDIA study between 1995 and 2011 (mean systolic BP, 109.7 mm Hg; mean age, 35 years; 57% women). With consideration of participants’ census tract, the data were linked to state, county and local-level smoke-free policies in bars, restaurants and/or non-hospitality workplaces. At baseline, 1.5% lived in areas with smoke-free policies in restaurants, 0.8% lived in areas with smoke-free policies in bars and 7.3% lived in areas with smoke-free policies in workplaces.
Systolic and diastolic BP were measured at year 10 (baseline), year 15, year 20 and year 25.
After adjusting for sociodemographic, health-related and policy/geographic covariates, researchers found that smoke-free policies were associated with differences between participants’ systolic BP and changes in individuals’ systolic BP.
At the end of follow-up, participants living in areas with smoke-free policies had lower systolic BP than those living in areas without smoke-free policies (mean difference in restaurant: –1.14 mm Hg; 95% CI, –2.15 to –0.12; bar: –1.52 mm Hg; 95% CI, –2.48 to –0.57; workplace: –1.41 mm Hg; 95% CI, –2.32 to –0.5).
In addition, it was determined that, within individuals, smoke-free policies in restaurants were associated with mean reductions in systolic BP of –0.85 mm Hg (95% CI, –1.61 to –0.09) and smoke-free policies in bars were associated with reductions of –1.08 mm Hg (95% CI, –1.82 to –0.34).
Reductions in individuals’ diastolic BP were only significant with smoke-free policies in restaurants (reduction of –0.58 mm Hg; 95% CI, –1.15 to –0.01), according to the researchers.
“Smoke-free laws were associated with reduced systolic blood pressure, but surprisingly not with reductions in diastolic blood pressure or high blood pressure,” Mayne said in the release. “It’s not entirely certain why this was the case, but it’s possible that we are detecting effects on systolic blood pressure that are below the threshold for hypertension.” – by Melissa J. Webb
Disclosures: The authors report no relevant financial disclosures.