Smoking associated with lower rates of BP control, even in patients taking medication

Overall, blood pressure control rates were similar between men and women (36.1% versus 32.5%, respectively), as was the prevalence of Stage 1, Stage 2 and Stage 3 blood pressure. Among never smokers, blood pressure categorization did not differ by gender. Among male never smokers, 37.1% fell into the controlled blood pressure category compared to 34.9% of female never smokers. Current smokers were associated with lower rates of blood pressure control among men and women, with only 9.1% of male current smokers categorized as having controlled blood pressure and 25% of female current smokers categorized as having controlled blood pressure. Male former smokers had 37.6% blood pressure control, which is a similar rate to male never smokers, while female former smokers had 23.8% blood pressure control, demonstrating a residual risk even with smoking cessation, said Gonçalves de Sousa.

"Middle-aged men are known to have lower adherence to treatment. When associated with a disease that neglects their own health, such as smoking, this association becomes easier to understand," he said

Behavioral factors and poor adherence to treatment are mechanisms that deserve further study, according to the researchers.

"Undoubtedly, addressing smoking cessation will be the biggest lever in achieving full health, thus reinforcing the need for better adherence to treatment," Gonçalves de Sousa said. "Although studies have not proven smoking cessation improves blood pressure control, we have found in clinical practice of resistant hypertensive patients that both smoking cessation and greater adherence to treatment are observed."