The role of smoking cessation programs in lowering blood pressure: A retrospective cohort study

Abstract

parameters, including blood pressure [7][8][9] . However, research results on the relationship between smoking cessation and blood pressure vary. Some researchers found a paradoxical association between cigarette smoking and blood pressure, with current smokers showing lower blood pressure than ex-smokers 7,10 or non-smokers 10,11 . In one study, smokers had higher daytime ambulatory systolic blood pressure than ABSTRACT INTRODUCTION Cigarette smoking affects blood pressure and is a major risk factor for cardiovascular diseases. The role of smoking cessation programs with respect to blood pressure remains inconclusive. Thus, this study aimed to investigate the effects of a smoking cessation program on blood pressure. METHODS Participants who attended the smoking cessation program in an outpatient clinic of a tertiary medical center in Taiwan from 2017 to 2018 were enrolled in this retrospective cohort study. Their smoking cessation status was traced via phone calls during the third month, and the researchers collected participant characteristics and blood pressure before and after the program. Differences in the participants' blood pressure, based on those with and those without hypertension, were compared using analysis of covariance. Univariable logistic regression models were used to determine factors associated with success in smoking cessation. In total, there were 721 participants. The participants had a mean age of 55.8±11.4 years and 68.1% of the participants were hypertensive. RESULTS During the program, the overall systolic blood pressure decreased by 4.0±17.9 mmHg and diastolic blood pressure decreased by 2.5±12.0 mmHg, from the baseline. Hypertensive participants showed a more prominent blood pressure lowering effect compared to non-hypertensive participants in terms of the subtraction difference of systolic blood pressure (-5.0±19.0 vs -1.9±15.2 mmHg, p=0.018) and diastolic blood pressure (-3.1±12.9 vs -1.1±9.6 mmHg, p=0.016). After multivariate control, the results showed that the adjusted subtraction difference of diastolic blood pressure was still more significant in the hypertensive group than in the non-hypertensive group. CONCLUSIONS The smoking cessation program significantly reduced both systolic blood pressure and diastolic blood pressure in the entire cohort. The results were more significant in the hypertensive group compared to the non-hypertensive group.

Lifestyle Subgroups and its Relationship with the Incidence of Hypertension in the Population of Azar Cohort: A Latent Class Analysis

“…In fact, ex-smokers are more aware of their blood pressure than non-smokers, pushing them toward quitting (53). On the other hand, a cohort study showed that smoking cessation signi cantly reduces blood pressure (54).…”

Effects of cigarette smoking on the response of hypertensive patients to beta-adrenergic antagonists: a narrative review

“…LMICs are particularly concerned because the continuous increase in smoking behavior will increase the burden of health care for high blood pressure [13]. The results were still paradoxical based on recent data on the relationship between cigarette smoking and elevated blood pressure [14][15][16][17]. The possible reasons for such a discrepancy among studies can be attributed to the long-term and cumulative effects of current smoking on health which may not result immediately in deleterious conditions [12].…”

“…The direct influence of cigarette smoking on hypertension cannot be sufficiently established because elevated blood pressure cannot be lowered by cessation of chronic smoking [7,18,19]. The role of smoking cessation programs regarding blood pressure remains uncertain [17]. As stated by Li et al [20], smoking cessation significantly decreases the risk of hypertension, and current smoking is not a risk factor for hypertension.…”

“…In contrast, another study illustrates that smoking is one of the prime preventable causes of hypertension, a condition that can be controlled to a large extent by smoking cessation [12]. Whereby conducting a smoking cessation program, there was a significant improvement in systolic and diastolic blood pressure [17]. Several confounding factors related to the lifestyle, diet, physical activity, and socioeconomic characteristics of individuals can affect the link between cigarette smoking and hypertension [15,21].…”

Impact of brief smoking cessation intervention on quitting rate and glycemic control in patients with diabetes: a randomized controlled trial

“…Studies show that smoking cessation programs can significantly reduce both systolic and diastolic blood pressure (BP), in addition to having an effect on glycemic control. 28,29 Previous studies have investigated the effectiveness of tobacco cessation interventions among patients with diabetes who smoke. 14,[30][31][32][33][34][35][36][37][38][39] The main limitation of those studies is that they were not randomized controlled trials (RCTs), and some studies included small samples or had inconclusive results.…”