Elevation of ambulatory systolic blood pressure in hypertensive smokers: a case-control study

Article Abstract:

Smoking is known to raise blood pressure while the cigarette is smoked and for 20 to 30 minutes afterwards, but the blood pressure of smokers and nonsmokers as measured in the physician's office is similar. To determine whether the blood pressure in everyday life of smokers is higher than that of nonsmokers, a review was carried out of the medical records of 59 cigarette smokers and 118 nonsmokers (the groups were matched for age, sex, race, and weight). All subjects had hypertension (elevated blood pressure) but were not taking antihypertensive medication. These patients had undergone 24-hour blood-pressure monitoring while carrying on their activities as usual; at regular intervals, their blood pressure was measured with a special inflatable device. Patients kept activity diaries so that the relationship between blood pressure and activity could be determined; smoking was not systematically recorded. Results showed no differences in blood pressure between the two groups (smokers, 141/93 mm Hg; nonsmokers, 142/93) when blood pressure was taken at the office. However, the systolic value (top number of a blood-pressure measurement, reflecting the arterial pressure as the heart contracts) during awake periods was significantly higher for smokers (145.0) than for nonsmokers (140.4). No differences in systolic values with respect to smoking status were seen during sleep, or in diastolic values (the bottom number) during sleep or wakefulness. The difference noted between smokers and nonsmokers in systolic blood pressure was only present in smokers 50 years of age or older. The higher blood pressure levels in smokers during the day are probably the result of smoking cigarettes, but the fact that the effect was confined to older subjects suggests that other factors besides the physiological effects of nicotine are operative. (Consumer Summary produced by Reliance Medical Information, Inc.)

Measurement, Physiological aspects, Smoking, Blood pressure, Blood pressure measurement

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Advances in the Treatment of Hypertension

Article Abstract:

The reports of many large clinical trials in 1998 have had a significant impact on the treatment of hypertension. One study showed that a diet rich in fruits and vegetables and low in saturated fat lowered blood pressure more effectively than other dietary interventions, including a low-sodium diet. A Mediterranean diet can lower deaths from cardiovascular disease and cancer. Moderate salt restriction and weight loss may allow some elderly patients to discontinue antihypertensive medication. ACE inhibitors and calcium channel blockers are no better than diuretics and beta blockers in lowering high blood pressure.

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Lifestyle modification and blood pressure control: is the glass half full or half empty?

Article Abstract:

Research has shown that changing more than one lifestyle behavior may not lower blood pressure any more than changing one. For example, weight loss and sodium restriction individually may lower blood pressure, but both combined may not lower blood pressure much further. Doctors should focus on weight loss, since it may be difficult for many people to change more than one lifestyle behavior. Patients who are not overweight could focus on dietary changes.

Health aspects, Editorial, Cooking, Life style, Lifestyles, Cookery for hypertensives

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