Δημήτρης Τούσουλης Καθηγητής,Ιατρική ΕΚΠΑ
Κωνσταντίνος Τσιούφης Αναπληρωτής Καθηγητής,Ιατρική, ΕΚΠΑ
Ελένη Κυρίτση Καθηγήτρια, Νοσηλευτική,ΑΤΕΙ
Objectives: Recent data suggest a positive relationship of smoking to heart disease in hypertensive patients. But the association of smoking with cardiovascular diseases among hypertensive patients is not sufficiently studied. Purpose: Consider the risk of cardiovascular disease compared with smoking in hypertensive patients with or without treatment, up, without a history of cardiovascular disease.
Methods:. 1699 patients with hypertension was examined (45.4% men, 11.5% smokers and 54.6% women, 12.4% smokers and 70.2% with uncontrolled hypertension), who visited the Hypertension Unit A University Clinic of Hippocratic Hospital for a mean of 3,5 ± 1,83 years. Firstly, At clinical data were recorded including tobacco use, drug use, blood pressure clinic, and it was performed a routine laboratory and ultrasound examination. The primary endpoint was defined as cardiovascular morbidity corresponding to the composite of coronary heart disease and stroke. The analysis of the data was done by using cox regression and χ2 and then adjusted for common risk factors and testing with t-statistic . The significance level was set at 5%. Results: In total there were 56 cardiovascular compatible of which 39 corresponded to coronary heart disease diagnoses and 17 strokes. Of univariate Cox regression study as independent variable smoking observed that smokers had 78.8% greater probability of cardiovascular events during follow-up (HR: 1,78, CI :95%:1.035-3.089, p=0,035). Also from the univariate Cox regression showed an independent correlation with cardiovascular compatible the cardiovascular events indicators such as smoking (HR: 2,56, CI: 95%:1,404-4,675, P= 0.002), age (HR: 1,03, CI : 95%:1,006-1,074, P=0.022), systolic pressure (HR: 1,02, CI: 95%:1,006-1,042, P=0.008), dyslipidemia (HR: 2,00, CI: 95%:1,103-3,645, P=0.023), male sex (HR: 4,97, CI: 95%2,428-10,202, P<0.001) and GFR (HR: 1,01, CI: 95%:1,002-1,034, P=0.026)
Conclusions: Prolonged smoking in hypertensive patients is related to heart diseases .The correct therapeutic approach for those patients should include the optimal antihypertensive treatment, quitting smoking strategies and physical activity.