Greater pulse pressure among smokers may help explain ties between smoking, CVD risk
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Greater pulse pressure among consistent smokers may contribute to higher CVD risk after middle age, according to results published in the Journal of the American Heart Association.
“There is a lack of information on the extent to which genetic differences in nicotine metabolism vs. psychosocial influences such as discrimination and racism influence BP among cigarette smokers,” Rachel E. Luehrs, PhD, assistant professor of exercise science in the department of health and human physiology at North Central College in Naperville, Illinois, and colleagues wrote. “However, it is possible that both genetic differences in nicotine metabolism as well as the effects of discrimination toward Black people may result in higher BP among Black smokers compared with white smokers.”
Researchers assessed 4,786 Black and white individuals from the CARDIA cohort study using repeated-measures regression models to evaluate the association between cigarette smoking and longitudinal 30-year changes in systolic and diastolic BP and pulse pressure.
In the cohort, 2,583 individuals were never smokers (mean age, 25 years; 56% women; 48% Black), 190 were long-term former smokers (mean age, 25 years; 58% women; 45% Black), 601 were consistent smokers (mean age, 25 years; 49% women; 65% Black) and 1,412 had other smoking patterns (mean age, 25 years; 54% women; 51% Black).
Compared with white never smokers, white consistent smokers demonstrated lower diastolic BP (beta = –2.27 mm Hg) and higher pulse pressure (beta = 1.59 mm Hg; P < .001 for both) but had similar systolic BP. Researchers observed no differences in systolic or diastolic BP between Black consistent smokers compared with Black never smokers, but Black consistent smokers demonstrated higher pulse pressure compared with Black never smokers (beta = 1.01 mm Hg; P = .028).
There were no differences in systolic and diastolic BP or pulse pressure between Black or white long-term former smokers compared with never smokers (P > .05 for all).
According to the researchers, based solely on results of diastolic BP being lower among consistent smokers and that cigarette smoking was not associated with higher systolic BP, it may be assumed that the association between smoking and CVD risk is not mediated through increased BP.
“Future studies are needed to determine whether the increase in pulse pressure with aging is greater among consistent smokers compared with never smokers and whether higher pulse pressure is associated with greater CVD risk in consistent smokers,” the researchers wrote. “Future studies are also needed to determine whether lower total vascular resistance contributes to the higher pulse pressure demonstrated in current smokers.”
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