Cigarette Smoking Interferes With Treatment of Hypertension

the Veterans Administration Cooperative Study Group on Antihypertensive Agents

Research output: Contribution to journalArticlepeer-review

14 Scopus citations


We retrospectively analyzed two studies to determine whether smoking affected the treatment of hypertension. In a study of the effects of propranolol hydrochloride (a hepatically metabolized β-blocker) vs hydrochlorothiazide, 108 smokers and 232 nonsmokers were randomized to the propranolol treatment group. The propranolol-treated smokers tended to be younger, taller, thinner, and were more likely to be black. This group also had an initial blood pressure reduction (± SD) of -7.9 ± 12.9/-8.7 ± 8.4 mm Hg compared with -10.7 ± 13.0/-10.9 ± 7.1 mm Hg for the nonsmokers. Blood pressure increased less during the one-year maintenance period for the nonsmokers. However, when analyzed by race, this effect was seen in blacks, but not in whites. Diastolic blood pressure tended to be reduced more in nonsmokers (vs smokers) receiving hydrochlorothiazide (-12.1 ± 6.7 vs -10.7 ± 6.7 mm Hg, respectively). The second study compared the effects of nadolol (a renally excreted β-blocker) with bendroflumethiazide. There were no significant effects on blood pressure for either of these drugs. In both studies, there was a greater tendency for smokers to be terminated from the study irrespective of drug group. We conclude that cigarette smoking does interfere with the treatment of hypertension in general, and especially with reduction of blood pressure by propranolol in black patients.

Original languageEnglish (US)
Pages (from-to)2116-2119
Number of pages4
JournalArchives of internal medicine
Issue number10
StatePublished - Oct 1988

ASJC Scopus subject areas

  • Internal Medicine


Dive into the research topics of 'Cigarette Smoking Interferes With Treatment of Hypertension'. Together they form a unique fingerprint.

Cite this