Effect of smoking on the course of essential hypertension: a follow-up study of a group composed predominantly of women.
BACKGROUND
The aim of this study was to compare the clinical course of essential hypertension between tobacco smokers and non-smokers.


METHODS
64 health service workers with essential hypertension were studied. The assessment consisted of anamnesis, physical examination, fundoscopic examination, ECG, echocardiography, routine laboratory investigations including lipid status, fasting insulin level, and urine analysis for microproteinuria. The efficacy of antihypertensive therapy was also evaluated. The period of observation was 18 months. Both subgroups were compared using the unpaired Student's t-test.


RESULTS
The subgroups did not differ significantly in sex structure (70% dominance of women), body mass index, BP values, or the duration of hypertension. The smokers were significantly younger, which points to the earlier origin of the disease in smokers (at the age of 42.1 +/- 11.0 years vs 50.8 +/- 8.5 years; p<0.001). The two subgroups did not differ in the frequency of left ventricular hypertrophy, stable angina pectoris, microproteinuria, or the degree of retinopathy. The smokers were characterized by higher serum total cholesterol (6.23 +/- 1.22 mmol/l vs 5.57 +/- 1.01 mmol/l; p<0.05) and triglyceride (2.53 +/- 1.72 mmol/l vs 1.6 +/- 1.21 mmol/l) concentrations. No other differences were found in laboratory investigations. BP normalization was attained in both subgroups, but the smokers required more drugs than the non-smokers (2.1 +/- 1.0 vs 1.7 +/- 0.6; p<0.01), though there were no significant differences in the dosage of particular agents.


CONCLUSIONS
We suggest that tobacco smoking causes earlier manifestation of essential hypertension, produces unfavorable changes in the lipid status, and decreases the efficacy of antihypertensive therapy.
Goldman
J
J
Cardiology Unit, District Hospital, Legnica, Poland.
Klinger
M
M
D000328:Adult; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D002784:Cholesterol / Q000097:blood; D004232:Diuretics / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000097:blood / Q000188:drug therapy / Q000503:physiopathology*; D007328:Insulin / Q000097:blood; D008297:Male; D008875:Middle Aged; D012907:Smoking / Q000503:physiopathology*; D014280:Triglycerides / Q000097:blood
D000806:Angiotensin-Converting Enzyme Inhibitors; D004232:Diuretics; D007328:Insulin; D014280:Triglycerides; D002784:Cholesterol