Smoking Related to 24-h Ambulatory Blood Pressure and Heart Rate: A Study in 352 Normotensive Danish Subjects

Abstract This study shows the association between smoking and both office and ambulatory blood pressure. By means of stratification, a uniform number of subjects of both sexes and spanning 6 decades (aged 20 to 79 years) were recruited randomly from the local community register. A total of 352 subjects participated, including 161 smokers. Smokers (both sexes and all age groups summed), as compared with nonsmokers had statistically significant lower office blood pressure as follows (mean systolic ± SED/mean diastolic ± SED): (systolic and diastolic, −6.8 ± 2.1/−3.9 ± 1.3); day ambulatory blood pressure (diastolic, /−2.8 ± 1.0); and night ambulatory blood pressure (systolic and diastolic, −4.2 ± 1.8/−3.9 ± 1.1). The intraperson variability of the day ambulatory blood pressure (as measured every 15 min) was identical for the smokers and the nonsmokers. Smokers were found to have a diminished “white coat” effect; this diminished white coat effect has not previously been described. The major white coat effect was seen in the older nonsmokers, whereas the diminished white coat effect was most pronounced in the older male smokers and in the younger female smokers. Smokers seem to have a diminished white coat effect, as well as a lower ambulatory blood pressure throughout the day (diastolic) and at night (systolic and diastolic). The similar intraperson variability found in the smokersʹ and nonsmokersʹ blood pressure further speaks for a consistently lower blood pressure in smokers as compared with nonsmokers.