title: Does smokeless tobacco cause hypertension?
abstract: This article reviews the literature regarding the cardiovascular effects of smokeless tobacco use. Articles were identified using a MEDLINE search of the English-language literature from 1966 to 1992 and a manual search of bibliographies of identified articles. From 875 articles regarding smokeless tobacco, 12 pertinent articles were identified. Smokeless tobacco caused a clinically significant acute elevation of systolic blood pressure, diastolic blood pressure, or pulse in 5 of 6 experimental trials. Smokeless tobacco was weakly associated with chronic hypertension in 4 of 6 cross-sectional studies. Health care practitioners should be aware that smokeless tobacco may elevate blood pressure up to 90 minutes after use. Smokeless tobacco use should be considered a potential cause of sodium retention and poor blood pressure control because of its nicotine, sodium, and licorice content.
authors.affiliation: Center for Health Services Research in Primary Care, Durham Veterans Affairs Medical Center, NC 27705, USA.
authors.forename: E C
authors.initials: EC
authors.lastname: Westman
mesh_terms: D003430:Cross-Sectional Studies; D006035:Glycyrrhiza; D006801:Humans; D006973:Hypertension / Q000139:chemically induced*; D016239:MEDLINE; D009538:Nicotine / Q000032:analysis; D010946:Plants, Medicinal; D010947:Plants, Toxic; D012964:Sodium / Q000032:analysis; D014030:Tobacco, Smokeless / Q000009:adverse effects* / Q000737:chemistry / Q000145:classification
chemical_list: D009538:Nicotine; D012964:Sodium