The Impact of Cigarette Smoking on 24‐Hour Blood Pressure,Inflammatory and Hemostatic Activity,and Cardiovascular Risk in Japanese Hypertensive Patients

The aim of the study was to assess the impact of current smoking on 24‐hour blood pressure (BP) and inflammatory and hemostatic activity and thereby the incidence of cardiovascular disease (CVD) in Japanese hypertensive patients. A total of 810 hypertensive patients (mean age 72 years; 38% men) were prospectively followed‐up (2799 person‐years). During the follow‐up, 66 cases of CVD occurred (stroke, 55; myocardial infarction, 7; both, 4). At baseline, the current smokers (n=166) had higher levels of high‐sensitivity C‐reactive protein (hs‐CRP) (0.21 mg/dL vs 0.14 mg/dL) and plasminogen activator inhibitor‐1 (PAI‐1) (46.1 ng/mL vs 37.8 ng/mL; both P=.001), but not of 24‐hour BP, compared with nonsmokers. Using a Cox regression analysis, current smoking was independently associated with an increased risk of CVD (hazard ratio [HR], 2.6; P<.01), and the risk was substantially higher in women (HR, 6.1; P<.001) than in men (HR, 1.4; P=.41). The CVD risk of current smokers was magnified when it was accompanied with high hs‐CRP (highest quartile range, ≥0.40 mg/L) or PAI‐1 levels (≥58.9 ng/mL) compared with that in smokers with low hs‐CRP or PAI‐1 levels (both P<.05). Among hypertensive patients, current smokers had increased risk of CVD events, and the increase was more prominent when accompanied by circulatory inflammatory and hemostatic abnormalities. J Clin Hypertens (Greenwich). 2012;00:00–00. ©2012 Wiley Periodicals, Inc.