Changes in blood pressure and body weight following smoking cessation in women

Janzon, Ellis; Hedblad, Bo; Berglund, Göran; Engström, Gunnar

doi:10.1046/j.1365-2796.2003.01293.x

Cited by 96 publications

(66 citation statements)

References 21 publications

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“…In non-pregnant women, cessation of smoking has been associated with a higher risk of hypertension than continued smoking or never smoking, 43 a finding that appears to support our results. Further study is needed to confirm a similar association between cessation of smoking and gestational hypertension.…”

Section: Mediating Mechanismssupporting

confidence: 89%

Maternal educational level and risk of gestational hypertension: the Generation R Study

et al. 2008

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We examined whether maternal educational level as an indicator of socioeconomic status is associated with gestational hypertension. We also examined the extent to which the effect of education is mediated by maternal substance use (that is smoking, alcohol consumption and illegal drug use), pre-existing diabetes, anthropometrics (that is height and body mass index (BMI)) and blood pressure at enrolment. This was studied in 3262 Dutch pregnant women participating in the Generation R Study, a population-based cohort study. Level of maternal education was established by questionnaire at enrolment, and categorized into high, mid-high, mid-low and low. Diagnosis of gestational hypertension was retrieved from medical records using standard criteria. Odds ratios (OR) of gestational hypertension for educational levels were calculated, adjusted for potential confounders and additionally adjusted for potential mediators. Adjusted for age and gravidity, women with mid-low (OR: 1.52; 95% CI: 1.02, 2.27) and low education (OR: 1.30; 95% CI: 0.80, 2.12) had a higher risk of gestational hypertension than women with high education. Additional adjustment for substance use, pre-existing diabetes, anthropometrics and blood pressure at enrolment attenuated these ORs to 1.09 (95% CI: 0.70, 1.69) and 0.89 (95% CI: 0.50, 1.58), respectively. These attenuations were largely due to the effects of BMI and blood pressure at enrolment. Women with relatively low educational levels have a higher risk of gestational hypertension, which is largely due to higher BMI and blood pressure levels from early pregnancy. The higher risk of gestational hypertension in these women is probably caused by pre-existing hypertensive tendencies that manifested themselves during pregnancy.

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Section: Mediating Mechanismssupporting

confidence: 89%

Maternal educational level and risk of gestational hypertension: the Generation R Study

et al. 2008

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“…A clinically important issue is that earlier literature reported that smoking cessation was associated with an increased incidence of hypertension. 50 In relation to this evidence, our decreasing trend of BP, partly explained by exercise effect, seems to be encouraging.…”

Section: Discussionsupporting

confidence: 54%

Smoking Cessation Program with Exercise Improves Cardiovascular Disease Biomarkers in Sedentary Women

Korhonen

Goodwin

Miesmaa

et al. 2011

Journal of Women's Health

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Background: Several cardiovascular disease (CVD) biomarkers sensitive to tobacco exposure have been identified, but how tobacco use cessation impacts them is less clear. We sought to investigate the effects of a smoking cessation program with an exercise intervention on CVD biomarkers in sedentary women. Methods: This is a cohort study on a subsample of a 2 · 2 factorial randomized controlled trial (RCT) (exercise setting: home vs. facility; level of exercise counseling: prescription only vs. prescription and adherence counseling) conducted January 2004 through December 2007. The analyses were completed in October 2010. In the greater Boston area, 130 sedentary female smokers aged 19-55 completed a 15-week program. All participants received nicotine replacement therapy (transdermal patch) and brief behavioral counseling for 12 weeks. They all received an exercise prescription on a moderate intensity level. All exercise interventions lasted for 15 weeks, from 3 weeks precessation until 12 weeks postcessation. Main outcome measures were selected CVD biomarkers hypothesized to be affected by smoking cessation or exercise measured at baseline and 12 weeks postcessation. Results: Independent of tobacco abstinence, improvement was seen in inflammation (white blood cells [WBC]), prothrombotic factor (red blood cells [RBC]), and cardiovascular fitness level (maximum oxygen consumption [Vo 2 max]). This suggests that even if complete abstinence is not achieved, reduction in tobacco exposure and increase in exercise can improve the cardiovascular risk profile. A significant decrease was seen for total cholesterol and the total cholesterol high-density lipoprotein cholesterol (HDL-C): ratio only among the abstainers. The heart rate was reduced among all participants, but this decrease was more profound among abstainers. A significant weight gain and body mass index (BMI) increase were observed among abstainers and those who relapsed. We also found an increase in hemoglobin A1c (Hb A1c), although significant only when the groups were combined. Conclusions: A smoking cessation intervention including exercise reduced tobacco-induced cardiovascular damage selectively within 3 months.

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“…This finding is consistent with longitudinal results, in which BP levels were lower in smokers in comparison to nonsmokers and the incidence of hypertension tended to increase after the cessation of smoking. 21 However, the mechanism beyond the effect of smoking on BP is uncertain.…”

Section: Discussionmentioning

confidence: 99%

Blood Pressure Control and Risk of Stroke

Engström

Hedblad

et al. 2005

Stroke

126

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Background and Purpose-Adequate control of blood pressure (BP) is a cornerstone in stroke prevention. This study explored the risk of stroke in relation to the quality of BP control in a population-based cohort and whether control of hypertension was related to background characteristics of patients. Methods-A total of 27 936 subjects (10 953 men and 16 983 women), 45 to 73 years old, living in Malmö, Sweden participated in the study. Incidence of stroke was followed-up for a mean period of 6 years. Controlled BP was defined as BP Ͻ140/90 mm Hg in subjects with pharmacological treatment for hypertension. Results-In the whole cohort, 16 648 subjects (60%) had hypertension (BP Ն140/90 mm Hg) and 23% of them received treatment. Among treated hypertensives, 88.2% had BP levels Ն140/90 mm Hg and 49.5% had BP levels Ն160/ 100 mm Hg. During the follow-up, 137 strokes occurred among treated hypertensive subjects. The crude incidence of stroke was 289/100 000 person-year in controlled hypertensive subjects and 705/100 000 person-year in treated hypertensive subjects with BP Ն140/90 mm Hg. It was estimated that Ϸ45% of all strokes among subjects with treatment for hypertension might be attributed to uncontrolled BP. In treated hypertensives, the risk of stroke increased significantly with advancing age, current smoking, high level of diastolic BP, and diabetes. In hypertensive subjects without treatment (nϭ12 819), incidence of stroke was 363/100 000 person-year. Conclusion-Uncontrolled BP is highly prevalent in patients with pharmacological treatment for hypertension. More than 90% of stroke in this group occurred in those with uncontrolled BP. Adequate hypertension control may prevent a substantial proportion of first-ever stroke among treated hypertensives.

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Changes in blood pressure and body weight following smoking cessation in women

Cited by 96 publications

References 21 publications

Maternal educational level and risk of gestational hypertension: the Generation R Study

Maternal educational level and risk of gestational hypertension: the Generation R Study

Smoking Cessation Program with Exercise Improves Cardiovascular Disease Biomarkers in Sedentary Women

Blood Pressure Control and Risk of Stroke

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