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Lorenzo Ghiadoni, Smoking and Central Blood Pressure: A Metabolic Interaction?, American Journal of Hypertension, Volume 22, Issue 6, June 2009, Page 585, https://doi.org/10.1038/ajh.2009.76
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Smoking is a well-known major cardiovascular risk factor, which can also influence blood pressure and metabolic profile. In this issue of American Journal of Hypertension, Minami et al.1 investigated the relationship between smoking and blood pressure by evaluating the influence of smoking habits on brachial and central blood pressure and radial augmentation index, a marker of peripheral wave reflection, in a population of Japanese healthy men. Metabolic syndrome incidence according to smoking was also assessed. Augmentation index was found to be higher in current as compared to never smokers and also in current heavy as compared to former smokers. Central systolic blood pressure was lower in never smokers than other groups, while this behavior was less evident for brachial blood pressure. Smoking status was an independent predictor of augmentation index and central systolic blood pressure, but not of peripheral blood pressure.
These results might suggest that smoking-associated alteration in wave reflection causes an increased central blood pressure. However, causality for this cannot be concluded upon the cross-sectional design of the study. Furthermore, this hypothesis cannot be completely supported because central arterial stiffness, the other major determinant of central systolic blood pressure,2 was not assessed in this study. Indeed, aortic pulse wave velocity rather than central blood pressure and augmentation index has been suggested to have independent predictive value for cardiovascular morbidity and mortality in high risk patients and in the general population.2 It should be also pointed out that differences in peripheral blood pressure varied in parallel with central hemodynamic parameters, although they did not reach statistical significance,1 possibly influencing the changes in central systolic blood pressure and augmentation index.2,3
