Risk of cardiovascular complications in hypertensive smokers and antihypertensive treatment: Metanalysis of small-case reports

Smoking is a risk issue for mortality and coronary cardiovascular disease in high blood pressure and in diabetes. The chance for stroke is a smaller amount consistent in high blood pressure and appears to be smaller than that of CHD in diabetes. High blood pressure is a powerful independent contributor to cardiovascular morbidity and mortality, on the average conferring a threefold increase in risk at all ages and in each sex. Coronary cardiovascular disease is currently the chief lethal abnormal condition of high blood pressure, occurring at a rate 2 to 3 times higher in hypertensives than in normotensives. The risk of cardiovascular morbidity and mortality is additionally greatly affected by cigarette smoking. For every ten cigarettes per day there's an progressive increase in cardiovascular mortality in men (18%) and in women (31%).

Antihypertensive drug

Antihypertensives drugs are a class of drugs that are used to treat hypertension. Antihypertensive therapy is to prevent the complications of high blood pressure (HighBP), such as myocardial infarction and stroke. Evidence suggests that the risk of stroke can be decrease to 34% by reduction of the blood pressure by 5 mmHg, of ischaemic heart disease by 21%, and reduce the heart failure, likelihood of dementia and mortality from cardiovascular disease. There are many classes of antihypertensive, which lower blood pressure by different means. Among the most important and most widely used drugs are calcium channel blockers, thiazide diuretics, angiotensin II receptor antagonists, ACE inhibitors, and beta blockers.

Metanalysis:

Metanalysis of large-scale trials showed combined action of hypertension (H) and smoking (S) as a potent risk factor for cardiovascular disease and both deaths and non-fatal events .The metanalysis of small-case reports of hypertensive smokers (Blood Pressure-BP- >140/90 mmHg) analyzing the incidence and type of cardiovascular complications  results observed indicated that a higher incidence of cardiac and cerebrovascular events affected hypertensive exposed chronically, current smokers, with a statistical significance, while smokers acutely exposed showed transient but stable increase in heart rate and systolic BP in all studied subjects. The type of pharmacological treatment does not influence the metanalysis results. Acute exposure to smoking increased heart rate and BP, while chronic exposure showed a significantly greater number of cardiovascular complications for S+H similarly to what observed in metanalysis of large-scale trials.