Parameters of ambulatory blood pressure monitoring in young patients with hypertension stages I and II with various smoking status

Smoking and arterial hypertension are the most common risk factors for cardiovascular diseases, the combination of which increases the risk of premature death by 2.1 times. Objective. To evaluate the parameters of ambulatory blood pressure monitoring (ABPM) in young outpatients with established diagnosis of hypertension (HT) stages I–II depending on smoking status. Material and methods. The study included 198 people aged 18–49 years, observed on an outpatient basis for hypertension stages I–II, who were divided into 3 groups: smokers (n = 72), ex-smokers (n = 59), and those who have never smoked (n = 67). The anamnesis data and ABPM parameters were analyzed in the three groups. Results. The second stage of hypertension was recorded more often in the group of smokers (66.7%). Daytime and nighttime indicators of average systolic (SBP) and diastolic (DBP) blood pressure, SBP and DBP time indices were increased in all groups. The highest ABPM values were recorded among continuing smokers, however, they did not reach statistically significant differences with the other two groups. The physiological profile – Dipper was detected most often in the group of never smokers, the Non-dipper profile was equally found – in the group of smokers and ex-smokers. The most unfavorable type - Night-peaker was recorded in a smoking patient. Conclusion. Smoking has an adverse effect on the course of hypertension, causing early involvement of target organs in the pathological process due to the prevalence of non-physiological BP profiles, as a result of which stage II hypertension is more often detected among the examined smokers. In the group of patients who quit smoking, pathological BP profiles were detected without significant differences from smokers, which indicates a residual risk among former tobacco users and justifies more thorough monitoring of BP and selection of antihypertensive drugs in them. In the group of never-smokers, despite the lack of influence of the fact of smoking on the mechanisms of increasing blood pressure, systolic blood pressure indicators were recorded that were very close to those in smokers, and maximum heart rate values, which requires separate clarification and study in connection with the possible involvement of other mechanisms of increasing blood pressure, the impact on which will allow effective control of the disease