Pediatric Academic Societies Annual Meeting
Pediatric Academic Societies Annual Meeting
May 02, 2019
2 min read

Secondhand smoke exposure increases children’s BP

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Karen Wilson, MD 2019
Karen Wilson

Research presented at the Pediatric Academic Societies Meeting has linked exposure to secondhand smoke to increases in diastolic and systolic blood pressure among children.

“Hypertension is one of the most costly and prevalent diseases, and childhood hypertension is associated with adult hypertension,” Karen Wilson, MD, MPH, professor of pediatrics and vice chair of clinical and translational research at the Icahn School of Medicine at Mount Sinai, told Infectious Diseases in Children. “If we could reduce tobacco exposure among children, we might be able to decrease the rate of hypertension among adults.

Wilson and colleagues analyzed data collected between 2007 and 2012 from the National Health and Nutrition Examination Survey. Secondhand smoke exposure was determined through serum cotinine and 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL) found in urine. The researchers calculated blood pressure percentiles based on 2017 guidelines.

Children and teens who were included in the study had an average age of 12.6 years, and 13.7% were living in a household with a smoker. The geometric means of NNAL and cotinine was 1.6 pg/mL and 0.06 ng/mL, respectively. Concentrations of NNAL and cotinine were significantly associated with the child’s race and/or ethnicity (P < .0001).

blood pressure monitor 
Children exposed to secondhand smoke may have increased diastolic and systolic blood pressure, according to research presented at the Pediatric Academic Societies Meeting.
Source: Shutterstock

Wilson and colleagues observed that higher levels of urinary NNAL were linked to increased diastolic BP (DBP) and systolic BP (SBP) percentiles. Boys were more likely to have increased DBP percentiles with increased NNAL, but the researchers did not find a significant association between SBP percentile and increased NNAL. Girls were more likely to have higher SBP percentiles with an increase in NNAL, but there was no significant association with DPB.

Furthermore, increased serum cotinine levels were linked to increased DBP percentiles in boys. This relationship was not observed in girls.

“Pediatricians and other health care providers should screen all of their patients for secondhand and thirdhand smoke exposure,” Wilson said. “If children are exposed, be clear with parents about the risks. Blood pressure should be measured, and if a child has elevated blood pressure or is diagnosed with hypertension, parents should be encouraged to quit smoking and referred for evidence-based treatment.” – by Katherine Bortz


Wilson K, et al. Secondhand smoke exposure and blood pressure in children and adolescents participating in NHANES. Presented at: PAS Meeting; April 24-May 1; Baltimore.

Disclosure: Wilson reports no relevant financial disclosures.