Smoking a marker for lower rates of BP control in patients with hypertension
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Smoking cigarettes was associated with lower rates of BP control among patients on medication to treat hypertension, according to an abstract presented at the American College of Cardiology Latin America Conference.
“Because the pathophysiological relationship between arterial hypertension and smoking is not clear, it is important for clinicians to have a better understanding of blood pressure control in smokers. Prior studies in men have shown an association, but in women there is little evidence so far,” Márcio Gonçalves de Sousa, MD, MIntMed, PhD, chief of the hypertension, smoking cessation and nephrology department at the Dante Pazzanese Institute of Cardiology in São Paulo, said in a press release. “In addition, there is synergy between these two risk factors: Hypertension exponentially increases the smoker’s cardiovascular risk and smoking increases the risk of hypertension, thus worsening their control.”
In a retrospective evaluation, researchers analyzed data from 710 adult hypertensive patients (69% women; mean age, 66 years) assisted from 2018 to 2019. Patients were then divided into three groups dependent on smoking status: never smoker, current smoker or former smoker. BP was measured in office and classified as controlled (BP < 140/90 mm Hg), stage 1 hypertension (BP 140-159/90-99 mm Hg), stage 2 hypertension (BP 160-179/100-109 mm Hg) or stage 3 hypertension (BP 180/100 mm Hg).
The study found that rates of controlled BP were similar across the sexes, as was the classification of stages 1 to 3 hypertension. Among those who had never smoked, 37.1% of men and 34.9% of women had controlled BP. However, in former smokers, 37.6% of men had controlled BP, similar to their nonsmoker counterparts, compared with only 23.8% of female former smokers, highlighting a residual risk even with smoking cessation, according to Gonçalves de Sousa. In current smokers, 9.1% of men had controlled BP compared with 25% of women.
“Middle-aged men are known to have lower adherence to treatment. When associated with a disease that neglects their own health, such as smoking, this association becomes easier to understand,” he said in the release.
“Undoubtedly, addressing smoking cessation will be the biggest lever in achieving full health, thus reinforcing the need for better adherence to treatment,” Gonçalves de Sousa said in the release. “Although studies have not proven smoking cessation improves blood pressure control, we have found in clinical practice of resistant hypertensive patients that both smoking cessation and greater adherence to treatment are observed.”
Reference:
- Smoking associated with lower rates of blood pressure control, even for patients taking medication. https://acc.org. Published Nov. 1, 2021. Accessed Nov. 1, 2021.
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de Sousa MG, et al. Abstract 143. Presented at: American College of Cardiology Latin America Conference; Nov. 5-6, 2021 (virtual meeting).
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