Smoking and hypertension.

Coronary heart disease is the most common cause of death in hypertensives--about twice as common as stroke. Smoking increases this raised risk of hypertension by some 2 to 3 times. Surprisingly perhaps, this increased risk from smoking declines rapidly on quitting--within 2-3 years. Smoking increases the risks of vascular damage by increasing sympathetic tone, platelet stickiness and reactivity, free radical production, damage to endothelium, and by surges in arterial pressure. The latter may interfere with the action of some hypotensive agents. Persuading hypertensive patients not to smoke is the single most effective measure we can take to reduce their risk.