How Smoking Affects Blood Pressure


Smoking increases the risk of developing systolic hypertension (your upper blood pressure reading) by at least 30%, increases the risk of coronary heart disease seven fold, and quadruples the risk of a stroke.

Smoking cigarettes causes your blood pressure to rise in several different ways as it exposes you to chemicals that:

  • damage blood vessel linings, leading to hardening and furring up of the arteries (atherosclerosis)
  • increase the stickiness of blood to increase your risk of unwanted blood clots (thrombosis and embolism)
  • displace oxygen from red blood cells (replacing it with poisonous carbon monoxide) so that less oxygen is available for use by all your cells, including those in your heart muscle and artery linings
  • trigger spasm of arteries all over your body, increasing blood pressure and decreasing blood flow to vital areas such as your heart and brain
  • increase secretion of growth factor beta-1, a substance that promotes fibrosis (scar tissue) in artery walls
  • produce harmful by-products (free radicals) which damage tissues, increase your risk of premature ageing (wrinkles) and are linked with over 90% of all cancers.

In the short term, smoking constricts your blood vessels through a direct effect on your sympathetic nervous system. As a result, your blood pressure can rise by 9/8mmHg every time you have a cigarette. If you both smoke a cigarette and drink coffee, the increase is even greater, causing a rise in blood pressure of as high as 21/17mmHg in some people. This effect means that people who smoke tend to require more drugs to control their hypertension, and higher doses, as the effectiveness of antihypertensive drugs (especially beta blockers and angiotensin II blockers) is reduced.

Nicotine is responsible for some of the arterial constriction, so nicotine replacement products are not always a good idea to help you quit smoking if you have very high blood pressure readings. Having said that, eCigarettes may be a safer alternative as long as you use them as a means to an end – that end being quitting altogether rather than the very serious health consequences of continuing to smoke.

In the long term, continued smoking hastens hardening and furring up of the arteries (atherosclerosis) which is one of the main underlying causes of a progressive rise in blood pressure leading to coronary heart disease and stroke. People who smoke tend to have thicker, less elastic arteries, and enlargement of the left ventricle of the heart. Smoking also increases the risk of developing poor kidney function, erectile dysfunction (impotence) in men, and poor circulation to the peripheries which, in extreme cases, can required amputation of a foot or leg.

Quitting Smoking Will Lower Your Blood Pressure

Within eight hours of stopping smoking, the level of oxygen in your circulation starts to increase. Within 48 hours, the stickiness of your blood and the r unwanted platelet clumping will reduce. Within three months, the flow of blood through your peripheral circulation will significantly improve.

  • Find support – stopping smoking is easier if you do it with a friend or relative who also wants to give up.
  • Keep your hands busy with activities such as drawing, painting, origami, knitting or DIY; according to psychologists, the hand-to-mouth habit is part of what makes quitting so difficult.
  • Exercise more as this releases opium-like endorphins within the brain to help curb withdrawal symptoms
  • Identify situations where you used to smoke and either avoid them or plan ahead to overcome them – practice saying ‘No thanks, I’ve given up’, or ‘No thanks, I’m cutting down’.

A gold-standard, Cochrane review recently examined all the evidence from clinical trials and concluded that people who use electronic cigarettes containing nicotine were more than twice as likely to abstain from smoking for at least six months than those using a placebo. For those cutting back, people using an electronic cigarette were 30% more likely to halve their cigarette consumption than those using a placebo and 41% more likely to cut back by half than those using a nicotine patch. But, as nicotine can cause blood pressure to rise, monitor your readings closely if you decide to use nicotine replacement products to help you quit.

If you currently smoke, consider taking pycnogenol – extracts from the bark of the French maritime pine. A dose of 125mg pycnogenol is as effective in preventing increased susceptibility to blood clotting in smokers as 500mg aspirin, but without the increased stomach-bleeding time seem with aspirin.

Although stopping smoking is hugely beneficial for your blood pressure, select healthy snacks to ensure you don’t put on weight as a result of the ‘munchies’ that nicotine withdrawal can cause.

If your blood pressure is borderline or raised, self-monitoring is key to maintaining good control.

Click here for advice on choosing a blood pressure monitor to  use at home.

See my recommended upper arm blood pressure monitors

Image credit: ratmaner/shutterstock




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