Does Smoking Affect Blood Pressure and Heart Rate?

Abstract

Background-Smoking is an important cardiovascular disease risk factor, but the mechanisms linking smoking to blood pressure are poorly understood. Methods and Results-Data on 141 317 participants (62 666 never, 40 669 former, 37 982 current smokers) from 23 population-based studies were included in observational and Mendelian randomization meta-analyses of the associations of smoking status and smoking heaviness with systolic and diastolic blood pressure, hypertension, and resting heart rate. For the Mendelian randomization analyses, a genetic variant rs16969968/rs1051730 was used as a proxy for smoking heaviness in current smokers. In observational analyses, current as compared with never smoking was associated with lower systolic blood pressure and diastolic blood pressure and lower hypertension risk, but with higher resting heart rate. In observational analyses among current smokers, 1 cigarette/day higher level of smoking heaviness was associated with higher (0.21 bpm; 95% confidence interval 0.19; 0.24) resting heart rate and slightly higher diastolic blood pressure (0.05 mm Hg; 95% confidence interval 0.02; 0.08) and systolic blood pressure (0.08 mm Hg; 95% confidence interval 0.03; 0.13). However, in Mendelian randomization analyses among current smokers, although each smoking increasing allele of rs16969968/rs1051730 was associated with higher resting heart rate (0.36 bpm/allele; 95% confidence interval 0.18; 0.54), there was no strong association with diastolic blood pressure, systolic blood pressure, or hypertension. This would suggest a 7 bpm higher heart rate in those who smoke 20 cigarettes/day. Conclusions-This Mendelian randomization meta-analysis supports a causal association of smoking heaviness with higher level of resting heart rate, but not with blood pressure. These findings suggest that part of the cardiovascular risk of smoking may operate through increasing resting heart rate. Key Words: blood pressure ◼ heart rate ◼ hypertension ◼ Mendelian randomization ◼ smoking S moking is a major risk factor for cardiovascular disease, but it is not clear by which mechanism smoking exerts its detrimental effects on cardiovascular disease. Generally, epidemiological studies have reported lower blood pressure levels among current smokers compared with nonsmokers. 1-14 On the contrary, smoking cessation has been reported to be followed by a decrease in blood pressure. 15,16 Whether the apparent association between smoking and lower blood pressure is causal or can be explained by confounding by lifestyle or socioeconomic factors related to both smoking and blood pressure remains an open question. Furthermore, smoking is causally associated with lower body mass index (BMI), 17 and higher level of adiposity is strongly associated with elevated blood pressure and is also considered a major risk factor for hypertension. 18,19 Hence, there is a strong possibility that the lower blood pressure observed in smokers could be explained by lower body weight caused by smoking. Data from observational epidemiological...

Health risk factors and the incidence of hypertension: 4-year prospective findings from a national cohort of 60 569 Thai Open University students

“…This is consistent with many other reports such as the longitudinal studies in Japanese49 and American men50 and a cross-sectional study in French men 51. In addition, smoking Jordanian men had a significantly higher blood pressure than their non-smoking counterparts 52. However, we also found that smoking had no influence on hypertension in women.…”

Blood Pressure Control in Smokers with Arterial Hypertension Who Switched to Electronic Cigarettes

“…Despite the strong relationship between smoking and elevated risk for cardiovascular disease [9,10], there is paucity and discrepancy about the long-term effects of smoking cessation on BP in already established hypertension [11,12,13]. …”

The Effect of an Animal-Assisted Intervention on Physiological Measures of Stress and Anxiety in Graduate Professional Physical Therapy Students

“…While it is not atypical to have a higher percentage of female students in a physical therapist educational program [58], the fact that females tend to exhibit greater levels of anxiety compared to males [1] [3] [4] [10], may have had an impact on our results and therefore future studies may want to further examine gender differences on anxiety outcomes. Another limitation to this study is that activity prior to the intervention was not controlled, such as engaging in exercise, consuming caffeine, smoking or other activities that can cause an increase in heart rate and blood pressure [59] [60]. Future studies may want to control for pre-intervention activity level as well as control for a history of hypertension and/or medications that may influence heart rate and blood pressure [59].…”

“…Another limitation to this study is that activity prior to the intervention was not controlled, such as engaging in exercise, consuming caffeine, smoking or other activities that can cause an increase in heart rate and blood pressure [59] [60]. Future studies may want to control for pre-intervention activity level as well as control for a history of hypertension and/or medications that may influence heart rate and blood pressure [59]. General atmosphere is another consideration for future re-…”