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more benefit !

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doc_clotaire
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12/12/07 - 12:35 PM

Which of the following non pharmacologic measures will give more benefit in a patient with Hypertension ?

Stop smoking or Stop Drinking ?

Please explain why ?

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jean robert
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12/12/07 - 03:43 PM

Stop smoking.

Related to endothelial lesion.

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SURVIVOR
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12/13/07 - 11:40 AM

Stop Smoking

i've heard of smoking being related to HTN far more intensely than alcohol! rolling eyes

Nicotine increases BP. CO causes endothelial injury which predisposes to atherosclerosis and I remember reading that smoking decreases NO synthesis, though I dont remember exactly how! (probably endothelial cell damage). Lowered NO levels would also tend to raise BP.

Alcohol raised BP because it causes the release of catecholamines (Goljan), which smoking also does!

So I'd go for STOP SMOKING! smiling face

new_n_lost
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12/13/07 - 01:16 PM

yeah stop smoking for the reasons of inducing endothelial injury.

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doc_clotaire
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12/13/07 - 10:54 PM

Sorry guys

Please try again and explain !

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deja_vu
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12/13/07 - 11:05 PM

Its modearation of alcohol. Endothelial damage leads to atherosclerosis but not to HT.
No relationship between smoking and HT. HT is related to Alcohol and obesity (if given in options).
Source: UW

SURVIVOR
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12/14/07 - 01:40 AM

No relationship between smoking and HT

There might be less of such a relationship than that between alcohol and HTN, but there definitely is an association between smoking and HTN! (according to Goljan)

the answer has to be alcohol but how? An alcoholic wouldn't strictly comply with anti-HTN medications? confused

new_n_lost
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12/14/07 - 06:02 AM

This is a slide from NEJM article on HTN. If it peaks your interest i can upload the whole article.

Attached Files:
Lifestyle modification for HTN 2003 NEJM.gif (21 KB, 4 downloads)

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deja_vu
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12/14/07 - 06:09 AM

Dr_Kashif wrote:

There might be less of such a relationship than that between alcohol and HTN, but there definitely is an association between smoking and HTN! (according to Goljan)

the answer has to be alcohol but how? An alcoholic wouldn't strictly comply with anti-HTN medications? confused

Hi Dr_Kashif,

http://hyper.ahajournals.org/cgi/content/full/37/...
These data show that any independent chronic effect of smoking on BP is small. Differences between men and women in this association are likely to be due to complex interrelations among smoking, alcohol intake, and BMI.

http://www.jhypertension.com/pt/re/jhypertension/...!1219373867!181195629!8091!-1
Independent effects of smoking on risk of hypertension: small, if present.

THIS IS MORE INTERESTING:
http://www.sciencedirect.com/science?_ob=ArticleU...
Conclusion: Chronic smoking reduces changes in blood pressure and 5-year cumulative incidence of hypertension.

http://www.blackwell-synergy.com/doi/abs/10.1111/...
After adjusting age and body mass index (BMI) in non-drinkers and age, BMI and alcohol intake in drinkers in forward stepwise multiple regression analysis, there was a dose-dependent negative relationship between cigarette smoking and diastolic blood pressure (DBP)
After matching age and BMI in non-drinkers, subjects who smoked more than 30 cigarettes/day had significantly lower mean values of systolic blood pressure (SBP; 4.3%; P<0.05)
shocked

deja_vu
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12/14/07 - 06:13 AM

#10

new_n_lost wrote:
This is a slide from NEJM article on HTN. If it peaks your interest i can upload the whole article.

We advise against cigaret smokin to every1... nod

Edited by deja_vu on 12/16/07 - 09:25 AM

doc_clotaire
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12/14/07 - 02:36 PM

#11

Cigarette smoking although increases the risk of cardiovascular substantially in patient suffering from hypertension , its moderation or cessation is NOT ASSOCIATED with a reduction of high blood pressure of high BP . Therefore cessation of cigarette smoking is srongly encourage in patients suffering from Hypertension but ONLY TO REDUCE THE RISK OF CARDIOVASCULAR AND NOT TO REDUCE HIGH BP

A CLEAR ASSOCIATION has been found betwen EXCESSIVE alcohol intake and development of hypertension . If average alcohol intake is greater than 2 drinks per day , Risk of development of Hypertension INCREASES by 1.5-2 times compared to general population and the risk increases substantially if average alcohol intake is greater than 5 drinks per day

On the other hand moderation of alcohol intake to 1-2 drinks per day also has been shown to have CARDIOPROTECTIVE EFFECT

Source : UW

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