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Tobacco & Heart Disease: The Deeper Story

Updated: Sep 15



Tobacco use is a major risk factor for high blood pressure (hypertension). The risk of high blood pressure and heart disease increases with the number of cigarettes smoked per day. Even after as few as 1 or 2 cigarettes per day, the risk of heart disease increases substantially. Cigarette smoking decreases the amount of oxygen that goes to your heart and increases your heart rate and blood pressure, which puts an extra burden on your heart. Smoking may damage blood vessels not only in your lungs but also throughout your body, including those that supply blood to your heart


Tobacco use is a big risk factor for high blood pressure (hypertension).



Tobacco use is a big risk factor for high blood pressure (hypertension). Research has shown that smoking can increase your risk of developing high blood pressure by as much as 40%. This connection between tobacco use and high blood pressure is also true for secondhand smoke exposure, which can lead to increased blood pressure in non-smokers. High blood pressure can lead to serious health problems including heart attacks, stroke and chronic kidney disease.


Smoking is known to increase the risk of:

  • Heart disease. Smoking increases your risk of coronary heart disease, which includes heart attacks, angina pectoris (chest pain), and coronary artery disease (narrowing or hardening of your arteries that can cause reduced blood flow).

  • High blood pressure. Smoking raises a person's blood pressure. This increases the risk for developing high blood pressure-related conditions such as stroke, kidney failure, and coronary artery disease (narrowing or hardening of the arteries that can cause reduced blood flow).

Smoking also increases the risk for peripheral vascular disease (decreased blood flow to your legs), which can lead to gangrene in some cases.



Cigarette smoking decreases the amount of oxygen that goes to your heart and increases your heart rate and blood pressure, which puts an extra burden on your heart.


Cigarette smoking decreases the amount of oxygen that goes to your heart and increases your heart rate and blood pressure, which puts an extra burden on your heart.

  • Cigarette smoke contains carbon monoxide, a poisonous gas. Your body uses oxygen from the air you breathe to help with normal cell functions such as breathing, absorbing nutrients from food, fighting infections and healing wounds. Carbon monoxide replaces some of this needed oxygen in your bloodstream by attaching itself to red blood cells (which carry oxygen). This reduces how much actual oxygen gets into your lungs and prevents vital organs like your brain or heart from getting enough of it.

  • Smoking also increases the force at which blood travels through arteries that connect major organs with artery walls (called pulse wave velocity). This can cause blocked arteries even before they become enlarged (or hypertensive).



Tobacco use is significantly associated with increased cardiovascular risk.


Tobacco use is significantly associated with increased cardiovascular risk.

Smoking is a major risk factor for heart disease. It increases the risk of heart attack, stroke, peripheral vascular disease (narrowing of the blood vessels outside your heart), and atrial fibrillation (irregular heartbeat). Smoking also increases the risk of heart failure in people who already have it. It can also cause aortic stenosis or regurgitation (stiffening or weakening of the aortic valve) in people who already have those conditions.


Cigarette smoking contributes to hypertension in multiple ways, including catecholamine release, vasoconstriction, and enhanced sympathetic activity. Catecholamines are stress hormones released from the adrenal glands that cause blood vessels to constrict in response to a perceived threat; this reduces blood flow to your heart. Smoking causes your body to produce more catecholamines than non-smokers do, which is why smoking can make your heart beat faster when you're stressed out or nervous. This explains why some smokers feel like they get high after drinking caffeine—it's because caffeine stimulates the sympathetic nervous system (which also governs fight-or-flight responses) by mimicking the effects of nicotine on catecholamine production.



Smoking increases the risk of aortic stiffness and accelerates elevated blood pressure (BP) into an earlier onset of clinical hypertension.


The research team noted that tobacco use is a significant risk factor for high blood pressure, and that smoking increases the risk of aortic stiffness and accelerates elevated BP into an earlier onset of clinical hypertension. Their findings suggest that smoking combined with other cardiovascular risk factors may lead to accelerated development of atherosclerosis, which can lead to heart attack or stroke.


“Our results suggest that smokers who are also hypertensive or have [aortic stiffness] should be considered as having premature [coronary artery disease],” said Dr. Anna Gudnason, MD, MPH, PhD, FACC at the University of Iceland in Reykjavik and lead author on the study. “Tobacco control remains an important issue globally; however more efforts are needed to prevent tobacco uptake among young people who are less susceptible to conventional preventive approaches such as taxation and public campaigns."


Current smokers have greater systolic and diastolic BP elevations than former smokers.



Current smokers have greater systolic and diastolic BP elevations than former smokers. The risk of hypertension is higher among current smokers than among former smokers. The risk of hypertension is lower in former smokers than in persons who have never smoked.


In addition to reducing the risk of hypertension, quitting smoking decreases the severity of BP elevation that accompanies aging.

  • Smoking cessation can reduce the risk for myocardial infarction, stroke and death from coronary heart disease.

  • Smokers have higher levels of nicotine in their blood than nonsmokers. The greater exposure to nicotine causes a faster increase in catecholamine release during stress, which contributes to increased sympathetic nerve activity (SNA). SNA accelerates heart rate and BP through activation of postsynaptic alpha2-adrenergic receptors located on cardiac muscle cells or vascular smooth muscle cells. This effect is enhanced by nicotine because it binds directly to beta-adrenergic receptors on vascular smooth muscle cells; however, nicotine has no direct effect on cardiac contractility or heart rate when given intravenously (Hosking & Barraclough 1994; Kloog et al., 2002).



Evidence suggests that tobacco use is a significant predictor of poor BP control among hypertensive patients.


Research suggests that tobacco use is a significant predictor of poor BP control among hypertensive patients. Tobacco use is associated with increased systolic and diastolic BP elevations and also with an increased risk of hypertension. Hypertension is a major public health problem due to its high prevalence, which affects 31% of the world's adult population.


Tobacco use significantly raises blood pressure and increases the risk of hypertension.


Tobacco use significantly raises blood pressure (BP) and increases the risk of hypertension. Smoking is considered a major contributor to the development of high BP, and tobacco use has been identified as a significant predictor of poor BP control among hypertensive patients. A number of studies have demonstrated that smoking cessation can lower BP in patients who are otherwise responsive to antihypertensive medications, although some people may not experience this effect until well after quitting.



The link between tobacco and heart disease has been clear for a long time.


The link between tobacco and heart disease has been clear for a long time. Smoking is the leading cause of preventable death in the United States, accounting for at least 480,000 deaths annually.[1] In fact, smoking accounts for one in five deaths from heart disease and stroke.[2]


Smoking increases your risk of heart attack and other cardiovascular diseases by multiple ways. First, smoking causes narrowing of blood vessels (known as atherosclerosis). This makes it harder for blood to flow through these vessels. When this happens to arteries that supply blood to your heart muscle or brain, you can have chest pain or a heart attack or stroke.[3] Second, smoking increases your risk of developing high blood pressure (hypertension).[4][5] High blood pressure damages the walls of your arteries over time leading them to become less flexible which means they can’t pump as well so less oxygen gets where it needs to go! Finally—and most importantly—smoking is directly linked with higher mortality rates after a first stroke.[6][7][8]




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