Does smoking cigarettes affect diastolic blood pressure?

From the Guidelines

Smoking cigarettes does affect diastolic blood pressure, and quitting is one of the most effective ways to improve blood pressure control. According to the most recent guidelines, smoking affects ambulatory blood pressure by raising daily BP, but effects of chronic smoking on office BP appear to be small 1. The mechanism behind this effect is likely due to the stimulation of the sympathetic nervous system, causing the release of catecholamines like adrenaline and noradrenaline, which constrict blood vessels and increase heart rate.

Key Points to Consider

• Smoking causes an immediate but temporary increase in both systolic and diastolic blood pressure, typically raising diastolic pressure by 5-10 mmHg for about 30 minutes after smoking a cigarette.
• Chronic smoking can damage blood vessel walls, causing them to become stiffer and less elastic, which contributes to sustained elevated blood pressure.
• Smoking cessation advice helps, but more intensive interventions are superior, and medications like nicotine replacement therapy, bupropion, or varenicline can help manage withdrawal symptoms during the quitting process 1.
• Blood pressure improvements may begin within days of quitting and continue to normalize over weeks to months as the cardiovascular system recovers.

Recommendations for Clinical Practice

• Smoking cessation is recommended to reduce CVD risk and improve non-CVD health 1.
• Healthcare providers should establish tobacco use status at each patient visit and counsel hypertensive smokers regarding giving up smoking 1.
• Smoking cessation medications and intensive interventions should be considered for patients who want to quit smoking.

From the Research

Effect of Smoking on Diastolic Blood Pressure

• Smoking cigarettes has been shown to affect diastolic blood pressure in various studies 2, 3, 4, 5, 6.
• A study published in 2014 found that heavy smoking was associated with increased diastolic blood pressure among Chinese nonagenarians/centenarians 2.
• Another study published in 2013 found that cigarette smoking resulted in significant acute alteration in the diastolic functions of both ventricles 3.
• Research has also shown that smoking can exacerbate the effect of blood pressure on the risk of cardiovascular and all-cause mortality among hypertensive patients 4.
• The addictive effects of smoking, particularly nicotine, can contribute to increased blood pressure and heart rate 5.
• However, switching to electronic cigarettes may aid smokers with arterial hypertension reduce or abstain from cigarette smoking, resulting in improvements in systolic and diastolic blood pressure as well as better blood pressure control 6.

Key Findings

• Heavy smoking is associated with higher diastolic blood pressure and prevalence of diastolic hypertension 2.
• Cigarette smoking can result in significant acute alteration in the diastolic functions of both ventricles 3.
• Smoking can increase the risk of cardiovascular disease and all-cause mortality among hypertensive patients 4.
• Nicotine in tobacco smoking can increase blood pressure and heart rate 5.
• Electronic cigarettes may be a useful tool for smokers with arterial hypertension to reduce or quit cigarette smoking and improve blood pressure control 6.