ArticleFrontiers in public health2022
Joint association of smoking and physical activity with mortality in elderly hypertensive patients: A Chinese population-based cohort study in 2007-2018.
Article in Frontiers in public health, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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11 citing papers in PubMed, 13 citations in OpenAlex.
- Visceral Adiposity Is Independently Associated with Hypertension in Thai Adults: A Case-Control Study.International journal of environmental research and public health · 2026Article
- Smoking Behavior and Major Cardiovascular and Limb Events in Patients With Peripheral Artery Disease.JAMA network open · 2026Article
- Association of combined healthy lifestyle factors with the risk of metabolic dysfunction-associated steatotic liver disease: the Korean National Health and Nutrition Examination Survey 2016-2021.BMC public health · 2026Article
- Inconsistent associations between central and peripheral arterial stiffness indices in relation to age.Quantitative imaging in medicine and surgery · 2026Article
- Geospatial and machine learning analyses of cardiovascular disease mortality across the continental United States: Identifying associated variables using Shapley values.BMC public health · 2026Article
- User Experiences With Digital Future-Self Interventions in the Contexts of Smoking and Physical Inactivity: Mixed Methods Multistudy Exploration.JMIR formative research · 2025Article
- The relationship between hypertension and health-related physical fitness in older adult residences in Wuhan: a cross-sectional study.Frontiers in public health · 2025Article
- Associations Between Changes in Physical Activity and Risk of All-Cause Mortality in Adults With/Without Hypertension - China, 2010-2022.China CDC weekly · 2024Article
- Exploring the Molecular Adaptations, Benefits, and Future Direction of Exercise Training: Updated Insights into Cardiovascular Health.Journal of functional morphology and kinesiology · 2024Review
- NHANES-based analysis of the correlation between leisure-time physical activity, serum cotinine levels and periodontitis risk.BMC oral health · 2024Article
- Association between myocardial layer-specific strain and high 10-year risk of atherosclerotic cardiovascular disease in hypertension-findings from the China-PAR project study.Frontiers in cardiovascular medicine · 2024Article
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Authors and funding
13 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Although associations of physical activity and smoking with mortality have been well-established, the joint impact of physical activity and smoking on premature mortality among elderly hypertensive population was still unclear. This study aimed to assess association of physical activity, smoking, and their interaction with all-cause and cardiovascular disease (CVD) mortality risk in elderly hypertensive patients. Methods: We included 125,978 Chinese hypertensive patients aged 60-85 years [mean (SD) age, 70.5 (6.9) years] who had records in electronic health information system of Minhang District of Shanghai, China in 2007-2015. Cox regression was used to estimate individual and joint association of smoking and physical activity on all-cause and CVD mortality. Interactions were measured both additively and multiplicatively. Additive interaction was evaluated by relative excess risk due to interaction (RERI), attributable proportion due to interaction (AP) and synergy index (S). Results: Among 125,978 elderly hypertensive patients (median age 70.1), 28,250 deaths from all causes and 13,164 deaths from CVD were observed during the follow-up up to 11 years. There was an additive interaction between smoking and physical inactivity [RERI: all-cause 0.19 (95% CI: 0.04-0.34), CVD 0.28 (0.06-0.50); AP: all-cause 0.09 (0.02-0.16), CVD 0.14 (0.04-0.23); S: all-cause 1.21 (1.04-1.42), CVD 1.36 (1.06-1.75)], while the concurrence of both risk factors was associated with more than 2-fold risk of death [hazard ratio (HR): all-cause 2.10 (1.99-2.21), CVD 2.19 (2.02-2.38)]. Conclusion: Our study suggested that smoking and physical inactivity together may have amplified association on premature death compared to the sum of their individual associations, highlighting the importance of improving behavioral factors in combination and promoting a comprehensive healthy lifestyle in hypertensive elderly.
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