BACKGROUND Heated tobacco products (HTPs) have emerged as alternatives to conventional cigarettes. However, their health effects remain largely unknown. This study aimed to prospectively explore the association between the use of cigarettes and HTPs and the risk of hypertension. METHODS This cohort study analysed data from 30 152 workers (82.0% men, mean age 42.9 ± 11.0 years) who were initially free of hypertension, participating in the Japan Epidemiology Collaboration on Occupational Health Study. Participants were categorized into five groups based on their self-reported tobacco product use: never smokers, past smokers, exclusive cigarette smokers, exclusive HTP users and dual users of cigarettes and HTPs. Hypertension cases were identified using three data points from annual health checkup data collected between 2019 and 2021. Cox proportional hazards regression models were used to investigate the association between tobacco product use and hypertension. RESULTS During a mean follow-up of 2.6 years (range: 0.1-4.0 years), 3656 new cases of hypertension were identified. Compared with never smokers, the risk of hypertension was higher among exclusive cigarette smokers [hazard ratio (HR) 1.26, 95% confidence interval (CI) 1.13-1.41] and exclusive HTP users (HR 1.19, 95% CI 1.06-1.34). There was also a suggestion of increased risk of hypertension among dual users (HR 1.16, 95% CI 0.98-1.38). Furthermore, the risk of hypertension increased with the intensity of cigarette/HTP use in all tobacco product users. CONCLUSIONS Similarly, both cigarette smoking and HTP use elevate the risk of hypertension. HTPs should not be regarded as less harmful alternatives to traditional cigarettes for preventing hypertension.

中文翻译：

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传统吸烟、加热烟草产品使用和双重使用与高血压的关联。


背景技术加热烟草产品(HTP)已经作为传统香烟的替代品出现。然而，它们对健康的影响在很大程度上仍然未知。本研究旨在前瞻性地探讨吸烟和 HTP 与高血压风险之间的关联。方法 这项队列研究分析了参加日本职业健康流行病学合作研究的 30 152 名最初没有高血压的工人（82.0% 为男性，平均年龄 42.9 ± 11.0 岁）的数据。根据参与者自我报告的烟草产品使用情况，将参与者分为五组：从不吸烟者、过去吸烟者、专门吸烟者、专门使用HTP 以及香烟和HTP 双重使用者。使用 2019 年至 2021 年间收集的年度健康检查数据中的三个数据点来识别高血压病例。使用 Cox 比例风险回归模型来研究烟草制品使用与高血压之间的关联。结果 在平均 2.6 年（范围：0.1-4.0 年）的随访期间，发现了 3656 例新的高血压病例。与从不吸烟者相比，仅吸烟者[风险比（HR）1.26，95%置信区间（CI）1.13-1.41]和仅吸烟者（HR 1.19，95% CI 1.06-1.34）患高血压的风险较高。还有建议表明双重使用者患高血压的风险增加（HR 1.16，95% CI 0.98-1.38）。此外，所有烟草制品使用者患高血压的风险随着卷烟/HTP使用强度的增加而增加。结论 同样，吸烟和使用 HTP 都会增加患高血压的风险。 HTP 不应被视为预防高血压的传统卷烟危害较小的替代品。