Medical perspective: does smoking cessation affect casual or ambulatory blood pressure?

Hypertension and smoking are common problems in the primary medical care setting. Together they interact to increase the incidence of cardiovascular disease [1]. Smoking increases the cardiovascular risk of hypertension for any level of systolic or diastolic blood pressure [1] possibly by effects on hemostatic function [2], lipoproteins [3], peroxidation and oxidative damage [4], or mechanisms yet to be determined. Accordingly, the fifth Joint National Committee (JNC-V) for the Detection, Evaluation, and Treatment of Hypertension guidelines recommend that hypertensive patients be routinely asked to stop smoking as a first-line lifestyle modification [5]. While the benefits of smoking cessation on cardiovascular risk are clear, the short- and long-term effects of smoking cessation on ambulatory blood pressure are largely unknown.