Relationship of Smoking to Hypertension in a Developing Country.

BACKGROUND: Smoking and hypertension are 2 leading causes of death worldwide, and it has been claimed that smoking is a cause of hypertension despite inconsistent results in the literature. In addition, the literature focuses mostly on developed countries, although more people in developing countries are adversely affected by smoking and hypertension.

OBJECTIVES: This study attempted to address critical limitations of the literature by analyzing a nationally representative survey of Indonesians with a large sample size and a long follow-up period.

METHODS: This study drew on the Indonesian Family Life Survey and followed men aged ≥15 years from 1993 to 2014. The sample size was 14,722 in the unbalanced panel data, 7,876 in the balanced data, and 12,715 in the cross-sectional data. Fixed-effects models were used to remove time-invariant individual characteristics for the panel data. These results were compared to those derived from the cross-sectional data in linear probability models, and the importance of controlling for time-invariant individual characteristics was assessed.

RESULTS: The results derived from fixed-effects models indicated no relation of smoking to hypertension. The relation remained null whether the unbalanced or balanced panel data, hypertension status or blood pressure, or smoking status or smoking intensity in linear or nonlinear form were analyzed. In contrast, the results derived from linear probability models exaggerated the relation.

CONCLUSIONS: Given the null relation, smoking was not associated with hypertension in this population.