SMOKING HABIT IS NOT RELATED WITH HYPERTENSION MEDIATED ORGAN DAMAGE IN YOUNG PATIENTS WITH FIRST DIAGNOSED AND NEVER TREATED ESSENTIAL HYPERTENSION

Abstract

Objective: Early onset arterial hypertension (AH) is associated with a considerably increased risk for cardiovascular (CV) disease. Cigarette smoking represents a significant CV risk factor. Aim of this study is the investigation of any differences between smokers and non smokers first diagnosed and never treated young patients with essential hypertension regarding the burden of blood pressure and the presence of hypertension-mediated organ damage (HMOD). Design and method: We studied 272 non-diabetic, first diagnosed and never-treated young hypertensive patients, [median age=43(39-48), 68% males]. Ambulatory blood pressure monitoring (24 h ABPM), CV risk factors [smoking, obesity (BMI), hyperlipidemia and HMOD [aortic stiffness (PWV), left ventricular diastolic dysfunction (EEa), cardiac hypertrophy (LVMI), coronary arteries microcirculation (CFR), carotid intima-media thickness (cIMT) and endothelial dysfunction (PBR5-25)] were estimated in each young patient before treatment initiation. Results: Young patients’ population was divided regarding smoking habit in smokers group [n = 105, age = 43(38–47), 75 males)] and non-smokers [n = 167, age = 43 (39–48), 119 males]. LDL-C levels, triglycerides, 24 h and daytime systolic ABPM, systolic and diastolic BP variability (BPV) and systolic BP load (BPL) during daytime were increased in smokers compared to non-smokers. No significant differences between smokers and non-smokers regarding age, BMI, E/Ea, LVMI, PWV, MAU, CFR, cIMT and PBR5–25 were found. However, the incidence of LVH (13% vs. 6%, p = 0.04) and impaired CFR (p = 0.05) was increased in smokers compared to non-smokers. In multiple regression analysis, we noted that 24 h systolic ABPM was independently associated with PWV (beta = 0.31, p < 0.001), LVMI (beta = 0.32, p < 0.001) and CFR (beta = -0.18, p = 0.01) regardless of smoking habit. Conclusions: In young people with first diagnosed arterial hypertension, HMOD is independently related to BP burden, irrespective of smoking habit. As HMOD may regress with successful antihypertensive treatment, there is still time for those young patients to treat hypertension disease and hyperlipidemia and quit smoking, in order to reduce future CV risk.