Joint effect of 25-hydroxyvitamin D and secondhand smoke exposure on hypertension in non-smoking women of childbearing age: NHANES 2007-2014

Abstract

Background Vitamin D deficiency (VDD) may increase the risk of hypertension in women of childbearing age, who may be exposed to secondhand smoke (SHS) simultaneously. Till now, few studies have investigated the joint effects of VDD and SHS on hypertension in this population. We evaluated whether exposure to SHS modified the association between VDD and hypertension. Methods Data from National Health and Nutrition Examination Surveys (NHANES) 2007-2014 were analyzed. Our research subjects were 2826 nonsmoking and nonpregnant women of childbearing age (20-44 years old). Hypertension was defined based either on systolic blood pressure (SBP) ≥ 130 mmHg and/or diastolic blood pressure (DBP) ≥ 80 mmHg or on now taking prescribed medicine for hypertension. The directed acyclic graphs (DAG) and the back-door criterion were used to select a minimal sufficient adjustment set of variables (MSAs) that would identify the unconfounded effect of 25(OH)D and hypertension. The interactive effect of VDD and SHS on hypertension was evaluated by using logistic regression models, followed by strata-specific analyses. Results The prevalence of VDD in the hypertension group was significantly higher than that in the non-hypertension group (48.2% vs 41.0%, P = 0.008), as well as the exposure rate of SHS (39.1% vs 33.8%, P = 0.017). VDD was independently associated with nearly 50% increased risk of hypertension [adjusted odds ratio (aOR) = 1.43, 95% confidence interval (CI): 1.01, 2.04], while no significant association was observed between SHS and hypertension. However, SHS showed a significant synergistic effect on VDD with a higher aOR of 1.79 (95% CI: 1.14, 2.80) (Pinteraction = 0.011). This synergistic effect was more obvious when stratified by BMI (in overweight women, aOR, 95% CI =4.74, 1.65-13.60 for interaction vs 2.33, 1.01-5.38 for VDD only) and race (in Non-Hispanic Black women, aOR, 95% CI =5.11, 1.58-16.54 for interaction vs 2.69, 1.10-6.62 for VDD only). Conclusion There exist synergistic effects of SHS and VDD on the prevalence of hypertension in American women of childbearing age, with more significant effects in women who were overweight or Non-Hispanic Black. Further studies are warranted to verify this finding in other populations, and the molecular mechanisms underlying the joint effect of SHS and VDD need to be elucidated.

Association of Serum 25(OH)D with Metabolic Syndrome in Chinese Women of Childbearing Age

“…25-hydroxyvitamin D [25(OH)D], the main form of circulating vitamin D, is widely applied as an indicator of vitamin D status. It is now well demonstrated that vitamin D also plays a role in many extra-skeletal health issues [ 2 ], such as metabolic syndrome (MetS) [ 3 , 4 ], type 2 diabetes mellitus (T2DM) [ 5 ], abdominal obesity [ 6 , 7 ], hypertension [ 8 , 9 ], and dyslipidemia [ 10 ].…”

Prevalence of Vitamin D and Calcium Deficiency and Insufficiency in Women of Childbearing Age and Associated Risk Factors: A Systematic Review and Meta-Analysis

“…The evidence showing that vitamin D deficiency can trigger negative outcomes for both the mother and child, including hypertension in women of childbearing age [ 9 ], gestational diabetes [ 10 ] and negative adverse perinatal outcomes [ 11 ] such as first trimester miscarriages [ 12 ] has resulted in a growing public health concern at primary care level and the need of public policies at the national level. Vitamin D deficiency has also been associated with some extra-skeletal damages, such as osteoporosis, chronic musculoskeletal pain, muscle weakness, and an increased risk of falling [ 13 , 14 , 15 , 16 ].…”

“…Vitamin D deficiency has also been associated with some extra-skeletal damages, such as osteoporosis, chronic musculoskeletal pain, muscle weakness, and an increased risk of falling [ 13 , 14 , 15 , 16 ]. The negative adverse perinatal outcomes [ 17 ] include impairment of anthropometric measurements of the neonate such as birth weight, length, and head circumference [ 18 ] in addition to a higher risk of premature rupture of membranes [ 10 ] and miscarriage [ 19 ]. At birth, it can be related to infantile eczema, nutritional rickets, severe hypocalcemia, and other orthopedic complications in neonates and children [ 20 ].Therefore, vitamin D deficiency in combination with periodontal disease has been associated with preterm and low birth weight [ 21 ].…”

Comparison of Vitamin D Levels and Related Factors in Pregnant Women and Neonates Exposed to Second-Hand Smoke

“…In another prospective study we conducted before, we determined that vitamin D levels were lower in preeclamptic pregnant women [ 6 ]. According to an article published in 2021, the findings suggested that vitamin D deficiency and passive smoking during pregnancy might have a synergistic impact on gestational hypertension [ 12 ]. Thus, it should be kept in mind that vitamin D deficiency and smoking may be important interrelated factors for hypertension in pregnancy.…”