Abnormal Blood Pressure Dipping in Smokers

AimHypertension with non-dipper or reverse dipper patterns has worse outcomes. Smokers have some risk factors for abnormal dipping. There are conflicting results about the association between smoking and blood pressure (BP) dipping patterns, thus we aimed to examine it in essential hypertension. Methods178 essential hypertension patients (ages 30-83) completed Fagerstrom Nicotine Dependence Test (FNDT) and our custom Patient Data Collection Test (PDCT). We analyzed these data with the ambulatory BP measurements (ABPM) and performed logistic regression analysis. ResultsAbnormal dipping patterns were significantly more frequent among patients with a history of smoking (75,0%) than those without history of smoking (47,4%), (p<0,001). Among smokers, abnormal dipping patients had significantly higher FNDT Scores (5 (0-10) versus 2 (0-9), p=0,046), longer smoking years (25 (6-50) versus 20 (5-50), p=0,017), and more smoking exposure in terms of pack.years (25 (3-135) versus 15 (1-75), p=0,023). Patients with history of smoking had significantly higher nocturnal systolic (128,10{+/-}15,54 versus 120,56{+/-}12,84 mmHg, p=0,001), nocturnal diastolic (80,82{+/-}12,60 versus 76,44{+/-}10,89 mmHg, p=0,016), and 24-hour mean systolic (133,15{+/-}13,52 versus 127,90{+/-}12,03 mmHg, p=0,008) BP values; and more blunted systolic and diastolic dipping ratios than non-smokers. Patients with a history of smoking were 3,484 (1,693-7,171 CI:0,95 p=0,001) times more likely to have abnormal dipping. Smoking was also associated with diabetes mellitus, dyslipidemia, and metabolic syndrome. ConclusionSmoking was associated with abnormal dipping patterns; higher nocturnal systolic, diastolic, and 24-hour systolic BP values; and lower systolic and diastolic dipping rates. FNDT score and smoking exposure parameters were significantly higher in abnormal dipping.