Abstract

Introduction: While smoking cessation reduces the risk of ischemic heart disease and stroke, it may be associated with weight gain. However, literature on the association between weight gain after smoking cessation and future hypertension is scarce. Methods: Of the 234,596 individuals who visited our health checkup center, 1085 individuals (mean age 47.5 ± 10.6 years; 1005 men) with previous history of smoking and available data after 5 years of smoking cessation were included. We compared the relationship between weight gain after smoking cessation and future hypertension (changes in blood pressure [BP] from baseline to 5 years, following smoking cessation and prescription rate of antihypertensive drugs. Multiple regression analysis was performed to evaluate changes in systolic and diastolic blood pressures (SBP and DBP) using covariates affecting BP changes from baseline values, such as weight gain, age, baseline weight, sex, and habitual alcohol consumption. Results: Since a median weight gain of 1.7 kg was observed after 1 year of smoking cessation, we divided participants into two groups: high weight gain (547 individuals, ≥1.7 kg) and low weight gain (538 individuals, <1.7 kg). There was no significant difference in the prescription rate of antihypertensive drugs between the two groups (high weight gain vs. low weight gain), at the baseline (10.6% vs. 10.4%; p = 0.92) and 5 years following smoking cessation (25.4% vs. 28.4%, p=0.26). Nevertheless, the changes in SBP (high weight gain vs. low weight gain: 7.9±15.4 vs 3.8±15.4 mmHg, p<0.001) and DBP (high weight gain vs. low weight gain: 4.2±10.5 vs 1.1±10.8 mmHg, p<0.001) from baseline to 5 years following smoking cessation were significantly higher in the high weight gain group. Additionally, multiple regression analysis showed that changes in SBP were influenced by high weight gain (β=-0.13, p<0.001) and age (β=0.06, p<0.05), while changes in DBP were influenced by high weight gain (β=-0.14, p<0.001), age (β=-0.10, p<0.001), and baseline weight (β=-0.10, p<0.01). Conclusions: Our results suggest that weight gain following smoking cessation subsequently leads to hypertension, and weight loss guidance may be useful in such cases.

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