Quitting smoking reduces hypertension in just 12 weeks – 7/5/2023 – Equilibrium

That smoking is bad for health is not news to anyone. Smoking is a chronic disease associated with increased risk of a number of other diseases, including cardiovascular disease. Several studies demonstrate that hypertensive smokers have a worse cardiovascular prognosis, even when treated with drugs for hypertension.

The novelty is that a study carried out at InCor (Instituto do Coração) of the Hospital das Clínicas of the Faculty of Medicine of USP (University of São Paulo) showed that quitting smoking reduces the blood pressure of hypertensive smokers in just 12 weeks, even among those who use medication for hypertension.

“Our study concluded that quitting smoking works as a remedy to treat hypertension. About 40% of patients in our outpatient clinic [de cessação do tabagismo] have comorbidities, including hypertension. This study found what we saw in clinical practice, which were hypertensive patients reducing the need to use the medicine because they stopped smoking and reached the goal of controlling their pressure”, points out the cardiologist Jaqueline Scholz, coordinator of InCor’s Smoking Treatment Program, study advisor and scientific adviser to Socesp (São Paulo State Cardiology Society).

The study gathered 361 participants who were undergoing treatment to stop smoking in the hospital – among them, 113 were smokers with hypertension who were taking medication to control blood pressure. The group was divided so that each one received different medications. Patients made six visits to the outpatient clinic and blood pressure levels were measured on the first day, after four and 12 weeks of treatment.

Of the group of hypertensive smokers, 72 people stopped smoking and another 41 did not, but reduced consumption. After the three-month period, blood pressure levels decreased among those who quit smoking (about 10 mmHg in systolic pressure, the highest value that appears when we measure it, and about 4 mmHg in diastolic pressure, the lowest value).

For the regulation of arterial hypertension, the ideal would be a diastolic blood pressure lower than 85 mmHg and systolic blood pressure lower than 130 mmHg.

“We did not interrupt the use of the hypertensive medication, but we observed a considerable clinical improvement. When we evaluated the blood pressure of these patients again, we saw that it was within the target, as if the fact of quitting smoking was another medication, as it potentiated the effects on blood pressure control”, points out the cardiologist. Participants who stopped the habit also had a reduced heart rate, another important marker for cardiovascular disease.

Cigarettes and hypertension

Smoking is not a direct cause of high blood pressure, but smoking is an aggravating factor in blood pressure, which makes this public have a worse evolution in the treatment of cardiovascular diseases.

The relationship between smoking and increased blood pressure involves a complex interaction between hemodynamic factors and the autonomic nervous system. In summary, the nicotine present in cigarettes generates an activation of the sympathetic nervous system and increases heart rate, blood pressure and, at the same time, reduces the supply of oxygen to the vessels and the heart.

According to the doctor, there are few studies with hypertensive smokers who have stopped smoking because the cessation rate in a hypertension outpatient clinic is very low. The idea of ​​carrying out the study came from observing the evolution of these patients in the clinical practice of the smoking outpatient clinic, since many hypertensive smokers who stopped smoking reported a reduction in the use of medication for the disease.

“The literature does not place smoking as a cause of hypertension, and it really is not. In this regard, we can say that this is one of the first studies that evaluate the impact of quitting smoking on hypertensive patients. a controlled and randomized study to prove this benefit”, said the cardiologist.

Smoking kills more than 440 Brazilians a day

According to the WHO (World Health Organization), about 8 million people die every year as a result of smoking. In Brazil, more than 440 people die every day from diseases associated with smoking, according to data from the Ministry of Health. Among the annual deaths attributable to smoking, 37,000 correspond to chronic obstructive pulmonary disease; 33,000 to cardiovascular diseases (including heart attacks and strokes); 24,400 thousand to lung cancer; 25,600 to other cancers; 18,600 to passive smoking, among other causes.

The work, which was carried out as part of a doctoral thesis, began in 2017 and was completed at the end of last year. The results were presented at a conference on smoking in the United States and the scientific article is in the process of being submitted for publication.

“We know that giving up smoking is not an easy task, but there is treatment and it is essential to improve quality of life and prevent other diseases, including improving blood pressure performance. Quitting smoking is the best thing people can do for her health”, concludes the cardiologist.