Smoking cessation decreases arterial blood pressure in hypertensive smokers: A subgroup analysis of the randomized controlled trial GENTSMOKING

Patricia V Gaya; Guilherme Wesley P Fonseca; Lucas Tsuyoshi Tanji; Tania O Abe; Maria Janieire N N Alves; Paulo Caleb Junior de Lima Santos; Fernanda M Consolim Colombo; Jaqueline R Scholz

doi:10.18332/tid/186853

Smoking cessation decreases arterial blood pressure in hypertensive smokers: A subgroup analysis of the randomized controlled trial GENTSMOKING

Tob Induc Dis. 2024 May 16:22. doi: 10.18332/tid/186853. eCollection 2024.

Authors

Patricia V Gaya¹, Guilherme Wesley P Fonseca², Lucas Tsuyoshi Tanji³, Tania O Abe¹, Maria Janieire N N Alves⁴, Paulo Caleb Junior de Lima Santos⁵, Fernanda M Consolim Colombo⁶, Jaqueline R Scholz¹

Affiliations

¹ Programa de Prevenção, Instituto do Coração, Hospital das Clinicas (HCFMUSP), Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil.
² Escola de Educação Física e Esporte, Universidade de São Paulo, Brazil.
³ Faculdade de Medicina (FMUSP), Universidade de Sao Paulo, São Paulo, Brazil.
⁴ Instituto do Coração, Hospital das Clinicas (HCFMUSP), Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil.
⁵ Departamento de Farmacologia, Escola Paulista de Medicina, Universidade de São Paulo, São Paulo, Brazil.
⁶ Unidade de Hipertensão, Instituto do Coração, Hospital das Clinicas (HCFMUSP), Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil.

Abstract

Introduction: High blood pressure in hypertensive smokers is affected by nicotine consumption. This study aimed to evaluate the effect of smoking cessation treatments on blood pressure in hypertensive smokers.

Methods: A total of 113 hypertensive smokers on antihypertensives during smoking cessation treatment in the randomized controlled trial GENTSMOKING were considered for analysis. At Baseline (T0) and Week 12 (T12), systolic and diastolic blood pressure (SBP and DBP), and heart rate (HR) were measured using a semi-automated digital oscillometric device. Mean arterial pressure (MAP) and delta differences for SBP, DBP, HR, and MAP were calculated. Smoking cessation was confirmed by measuring carbon monoxide (CO) in exhaled air.

Results: After 12 weeks of treatment, 72 participants ceased smoking (cessation group) and 41 did not (no cessation group). At T0, there was no statistically meaningful difference between groups with respect to age, body mass index, CO, and daily cigarette consumption. At T12, daily cigarette consumption and CO had decreased in both groups (p<0.001). The cessation group showed decreased SBP (131 ± 2 vs 125 ± 2 mmHg, p=0.004), DBP (79 ± 1 vs 77 ± 1 mmHg, p=0.031), MAP (96 ± 1 vs 93 ± 1 mmHg, p=0.005), and HR (79 ± 1 vs 74 ± 1 beats/min, p=0.001), and increased body weight (77.4 ± 2.1 vs 79.2 ± 2.2 kg, p<0.001). No significant differences were seen for these variables in the no cessation group. Decrease in blood pressure was significantly higher among hypertensive participants with SBP ≥130 mmHg: SBP (145 ± 2 vs 132 ± 2 mmHg, p<0.001), DBP (85 ± 2 vs 80 ± 1 mmHg, p=0.002), MAP (105 ± 1 vs 97 ± 1 mmHg, p<0.001), and HR (81 ± 2 vs 74 ± 2 beats/min, p=0.002). A positive correlation was found between HR and CO (r=0.34; p=0.001).

Conclusions: Smoking cessation treatment reduced blood pressure in hypertensive smokers, allowing them to reach therapeutic targets for hypertension management. Smoking cessation has a positive impact on hypertension treatment; therefore, it should be encouraged in clinical practice.

Clinicaltrialsgov identifier: NCT03362099.

Keywords: blood pressure; hypertension management; smoking cessation.

Associated data

ClinicalTrials.gov/NCT03362099

Grants and funding

FUNDING The GENTSMOKING randomized controlled trail (NCT03362099) was funded by CNPq (Conselho Nacional de Desenvolvimento Científico e Tecnológico) and FAPESP (Fundação de Amparo à Pesquisa do Estado de São Paulo).