0
We're unable to sign you in at this time. Please try again in a few minutes.
Retry
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
Retry
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
ARTICLE |

Cigarette Smoking Interferes With Treatment of Hypertension

Barry J. Materson, MD; Domenic Reda, MS; Edward D. Freis, MD; William G. Henderson, PhD; Frederick N. Talmers, MD; William C. Cushman, MD; Harold Schnaper, MD; Thomas J. White, MD; Khin Mae Hla, MD; Orlando Fernandez, MD; Eli A. Ramirez, MD; Ibrahim Khatri, MD; Barbara Gregory, RN; Madeline Metcalfe, RN; Julie Pawelak, RN; Pauline Derrington, RN; Susan Reece, RN; Kristina Grossman, RN; Mary Smith, RN; Eileen Haran, RN; Maria Natal, RN; Donald Quinn, PA; Bor Ming, Ou, MS; Samuel B. Lindle, PhD; Walter Flamenbaum, MD; Robert Hamburger, MD; Larry Young, RPh; F. Gilbert McMahon, MD; Ray Gifford Jr, MD; C. Morton Hawkins, PhD; James R. Oster, MD; Ezra Lamdin, MD; Shig Ochi, PhD; J. R. Thomas, MD; Jennie McKoy; Patrick Moran; Mary Davidson, PhD; Kenneth Elmer; James A. Hagans, MD, PhD; Ping Huang, PhD; Kenneth James, PhD; Mike Sather, RPh, MS; Chris Grant, RN; Anita McKnight, RN; William Hackett, RN; Thomas J. Tosch, PhD; Janice Ivie; Mary Ellen Vitek; Jane Foregger; Walter Kirkendall, MD; James C. Gunnels, MD; C. Morton Hawkins, DS; John C. Alexander, MD; Joseph Meyer, PhD; Dionisio L. Caloza Jr, MD
Arch Intern Med. 1988;148(10):2116-2119. doi:10.1001/archinte.1988.00380100014004.
Text Size: A A A
Published online

• 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.

(Arch Intern Med 1988;148:2116-2119)

Topics

Sign in

Create a free personal account to sign up for alerts, share articles, and more.

Purchase Options

• Buy this article
• Subscribe to the journal

Figures

Tables

References

Correspondence

CME
Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
Submit a Comment

Multimedia

Some tools below are only available to our subscribers or users with an online account.

Web of Science® Times Cited: 14

Sign in

Create a free personal account to sign up for alerts, share articles, and more.

Purchase Options

• Buy this article
• Subscribe to the journal

Related Content

Customize your page view by dragging & repositioning the boxes below.

Jobs
brightcove.createExperiences();