Oncken C A, White W B, Cooney J L, Van Kirk J R, Ahluwalia J S, Giacco S
Department of Medicine, University of Connecticut School of Medicine, Farmington 06030-3940, USA.
Am J Hypertens. 2001 Sep;14(9 Pt 1):942-9. doi: 10.1016/s0895-7061(01)02147-1.
Smoking and hypertension interact to increase the incidence of cardiovascular disease; however, little is known about the effects of smoking cessation on blood pressure (BP) control. We prospectively evaluated the impact of smoking cessation on clinic and ambulatory BP and heart rate (HR) in stage 1 hypertensive and normotensive postmenopausal women.
A total of 66 women were randomly assigned using a 3:1 randomization scheme to immediate smoking cessation or to a wait list control group. Clinic and ambulatory BP and HR, and 24-h urinary catecholamine concentrations were obtained at baseline and again at 6 weeks. Carbon monoxide levels and self-report were used to assess compliance with smoking cessation.
Ambulatory monitoring showed that the awake SBP decreased by 3.6+/-1.9 mm Hg in the treated subjects who quit smoking (n=19), whereas in the control group (n=15) there was an increase of 1.7+/-2.4 mm Hg (P=.045). Awake HR decreased after smoking cessation by 7+/-1 beats/min and did not change (0+/-1 beat/min) in the control group (P=.001). Blood pressure and HR did not significantly change during sleep after smoking cessation. Changes in the awake HR correlated with changes in urinary epinephrine concentrations (r= 0.58, P=.001), and norepinephrine concentrations (r= 0.45, P=.001), There was no significant change in clinic systolic BP, diastolic BP, or HR between groups.
Smoking cessation reduces systolic BP and HR during the daytime, when patients typically smoke. These hemodynamic changes are due in part to reductions in sympathetic nervous system activity.
吸烟与高血压相互作用会增加心血管疾病的发病率；然而，关于戒烟对血压（BP）控制的影响却知之甚少。我们前瞻性地评估了戒烟对1期高血压和血压正常的绝经后女性的诊室血压、动态血压及心率（HR）的影响。
总共66名女性按照3:1的随机分组方案被随机分配至立即戒烟组或等待名单对照组。在基线时以及6周后再次测量诊室血压、动态血压及心率，以及24小时尿儿茶酚胺浓度。通过一氧化碳水平和自我报告来评估戒烟的依从性。
动态血压监测显示，戒烟的治疗组受试者（n = 19）清醒时收缩压下降了3.6±1.9 mmHg，而对照组（n = 15）则上升了1.7±2.4 mmHg（P = 0.045）。戒烟后清醒时心率下降了7±1次/分钟，而对照组未发生变化（0±1次/分钟）（P = 0.001）。戒烟后睡眠期间血压和心率没有显著变化。清醒时心率的变化与尿肾上腺素浓度的变化相关（r = 0.58，P = 0.001），与去甲肾上腺素浓度的变化也相关（r = 0.45，P = 0.001）。两组之间诊室收缩压、舒张压或心率没有显著变化。
戒烟可降低患者通常在白天吸烟时的收缩压和心率。这些血流动力学变化部分归因于交感神经系统活动的降低。
