Cigarette smoking ups risk of masked daytime ambulatory, evening home hypertension

Cigarette smoking appears to elevate the risk of masked daytime ambulatory and evening home hypertension, reveals a recent study. This association is more pronounced among heavy smokers or older men.

In multiple logistic regression, current cigarette smoking demonstrated a significant association with daytime (prevalence, 18.7 percent; odds ratio [OR], 1.69, 95 percent confidence interval [CI], 1.27–2.25; p=0.0003) but not night-time (prevalence, 27.1 percent; p=0.32) ambulatory masked hypertension. Cigarette smoking also correlated with evening (prevalence, 14.6 percent; OR, 1.81, 95 percent CI, 1.33–2.47; p=0.0002) but not morning (prevalence, 17.6 percent; p=0.29) home masked hypertension.

The increased risks of hypertension were higher for heavy smoking (≥20 cigarettes/day) compared to never smoking for both masked daytime ambulatory (OR, 1.97; p=0.001) and evening home hypertension (OR, 2.40; p<0.0001) or in patients aged >55 years (p_interaction=0.005 in relation to daytime ambulatory masked hypertension).

Significant associations (p<0.01) were also seen in men with clinic normotension (n=742), particularly in those with a normal to high-normal clinic blood pressure (BP; n=619; p<0.04).

This study included a total of 1,646 men (494 current smokers; 30.0 percent) to examine the prevalence of masked hypertension in relation to cigarette smoking in Chinese outpatients enrolled in a multicentre registry. Masked hypertension was defined as normal clinic systolic (S)BP/diastolic (D)BP (<140/90 mm Hg) and elevated daytime (≥135/85 mm Hg) or night-time (≥120/70 mm Hg) ambulatory or morning or evening home SBP/DBP (≥135/85 mm Hg).

“Smokers may smoke cigarettes during ambulatory or home BP monitoring but not clinic measurement,” the authors noted.