P.074 Effect of Smoking on Arterial Stiffness in Patients with White Coat Hypertension

Abstract

Background

Patients with essential hypertension have higher arterial stiffness indices, while smoking is related to a stiff vascular tree. However, the effect of smoking on arterial stiffness in white coat hypertensive (WCH) patients has not been investigated yet.

Methods

The study comprised 375 WCH patients (mean age 52 years, 149 male). The diagnosis of WCH was confirmed by a 24h Ambulatory Blood Pressure Monitoring (ABPM) into normal range. The augmentation index (AIx), a measure of arterial wave reflections, was measured by applanation tonometry (SphygmoCor), while carotid-brachial Pulse Wave Velocity (PWVc-r) and carotid-femoral PWV (PWVc-f) were measured with Complior. AIx was corrected for heart rate (AIx₇₅). Current smoking status was assessed with a standardized questionnaire.

Results

The study cohort was divided in 129 smokers and 246 non-smokers, who did not differ in SBP, BMI, heart rate and total cholesterol (p = NS). In multivariate analysis after adjusting for age and gender, AIx₇₅ was higher in smokers compared to non-smokers (26.8 vs 22.5, p<0.001). PWVc-r was also higher in smokers compared to non-smokers (8.3 ± 0.9 vs 8.0 ± 1.2, p<0.05), while no significant difference was noticed in PWVc-f. When we examined the correlation of smoking with the arterial stiffness indices, we noticed a significant correlation of AIx₇₅ with pack-years (r = 0.278, p<0.001), while the stronger correlation was noticed in years of smoking with PWVc-f (r = 0.425, p<0.001) and with AIx₇₅ (r = 0.649, p<0.001). After adjusting for age and gender, the correlation of years of smoking with AIx₇₅ remained significant (r = 0.355, p<0.0001).

Conclusion

Smoking affects wave reflections and arterial stiffness in WCH patients. Specifically, intensity/duration of smoking affects both wave reflections and arterial stiffness whereas smoking duration is a burden only to wave reflections.