Smoking raises your blood pressure in the short term and over a long period of time, putting both young and old smokers at high risk of developing hypertension (high blood pressure), compared to those who do not smoke.

A longitudinal study of nearly 29,000 people, ages 36 to 80 found that smoking not only raises blood pressure over time, but also puts you at higher risk of developing atherosclerosis, a chronic, progressive disease in which plaques build up in the walls of arteries. The study cites smoking as an independent risk factor for cardiovascular disease.1

Smoking activates your sympathetic nervous system, which releases chemicals that swiftly increase blood pressure. Long-term smoking contributes to the development of chronic hypertension by accelerating arterial aging, or how quickly the arteries become damaged.

Effects of Smoking on Your Cardiovascular System 

Cigarette smoking is a major preventable cause of premature cardiovascular disease, with the risk particularly high in people with hypertension. Cigarette smoking increases the likelihood of having a heart attack or stroke because it adds to the damage done to the blood vessels by high blood pressure and high cholesterol levels.

Chronic smoking also stiffens the arteries making them less flexible as blood passes through them. As a result the body has to work harder to move blood through the body in cigarette smokers.2

Smoking is also particularly dangerous in those with high blood pressure because cigarette smoke damages the kidneys and increases the likelihood of experiencing severe blood pressure spikes called malignant hypertension or a hypertensive emergency.

Malignant hypertension occurs when your blood pressure is at or over 180/120 mmHg.3 At this level, organ damage can occur, therefore malignant hypertension is an emergency and should be treated immediately by a healthcare professional. 

Nicotine, the addictive chemical found in combustible cigarettes and other tobacco products, has been found to acutely increase blood pressure through its effects on the sympathetic nervous system.4 Therefore all people, especially those who already have hypertension, should quit smoking as soon as possible.

Many people, including cigarette smokers, are unaware that they have high blood pressure because the symptoms are nonspecific and therefore can be attributed to many other medical conditions.

Dangers of High Blood Pressure

As previously mentioned, high blood pressure puts you at higher risk of developing:

• Malignant hypertension
• Essential hypertension
• Kidney disease
• Heart attack
• Stroke

Other complications include:

• Metabolic syndrome
• Dementia or Alzheimer’s disease
• Sexual dysfunction
• Peripheral artery disease

If you experience any symptoms of high blood pressure, call 911 or visit the nearest emergency hospital right away to help avoid these life-altering and sometimes fatal complications. 

Does Quitting Smoking Lower Blood Pressure?

Quitting smoking along with making small changes to your habits like eating a low sodium diet, getting regular exercise, maintaining a healthy weight, and limiting alcohol intake can lower your blood pressure by 10 to 20 mmHG or more.

Quitting earlier is best to avoid irreversible damage to our blood vessels but even if you are a longtime smoker it is never too late to quit. Smoking also increases your risk of other conditions like lung cancer, COPD, and emphysema so the health benefits of quitting are enormous.

In the United States, the estimated number of tobacco smokers has dropped, as a result of tobacco-control efforts, from 45.1 million smokers in 2005 to 36.5 million smokers in 2017.6 That number is expected to continue to drop although the rise in use of smokeless tobacco has caused some opposition.

Prevention

The most effective way to prevent hypertension is to eliminate unhealthy habits like smoking. Not only does smoking and exposure to secondhand smoke raise your blood pressure, but it also puts you at a higher risk for heart attack and stroke. The only way to be sure that you are not being negatively impacted by smoking is to avoid it altogether.

Although much progress has been made, far too many young people use tobacco. Even more troubling, the rates of decline for smokeless tobacco have stalled or risen as of late. This is of particular concern because nicotine addiction can prolong tobacco use and lead to severe health complications.

As a result, the medical and public health communities cannot emphasize enough the importance of discouraging all forms of tobacco use in young people. 

A Word From Verywell

Oftentimes there are no obvious symptoms of hypertension hence why it is often called a silent killer, underscoring the importance of knowing your risk factors for developing hypertension and adopting a healthy positive routine that includes healthy eating and exercise.

Taking high blood pressure seriously and following your doctor’s treatment recommendations can lower your risk of serious complications and make a big difference in your overall health. 

Hypertension can impact anyone and it is not always the result of unhealthy habits like cigarette smoking. If you experience high blood pressure symptoms, contact a healthcare professional immediately. While there is no cure for hypertension, most causes can be managed effectively through lifestyle changes and medication, when needed. 

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TOCHIGI, Japan — People who have high blood pressure while asleep are more likely to suffer cardiovascular disease, especially heart failure, in the future, a new study reveals. In fact, researchers at Jichi Medical University in Japan warn that even when a patient’s daytime blood pressure is within normal ranges, they are still more likely to have a heart attack or a stroke.

Medical practitioners typically use in-office and daytime blood pressure measurements to determine a patient’s hypertension medication needs and dosages. But many patients may have undetected high blood pressure while sleeping, also known as nocturnal hypertension, scientists say.

“Nighttime blood pressure is increasingly being recognized as a predictor of cardiovascular risk,” says lead author Professor Kazuomi Kario, a professor of cardiovascular medicine, in a statement to the American Heart Association. “This study provides much more in-depth information about the cardiovascular risk associated with high nighttime blood pressure and different nighttime blood pressure phenotypes than have been reported previously.”

Patients’ blood pressure monitored during the day and while sleeping

For the study, data was collected from 6,359 adults from across Japan between 2009 and 2017. Nearly half of the study participants were male, and more than half were at least 65 years old. The patients all had at least one cardiovascular risk factor, and three-quarters of them were taking blood pressure medications. None had symptomatic cardiovascular disease when the study began.

Researchers measured daytime and nighttime blood pressure levels using an at-home, wearable monitor. Measurements were taken for at least 24 hours at a time, and device data were periodically downloaded at a health care clinic. Participants were instructed to self-report their daily activities along with sleep and wake times in a diary. A

Almost every participant recorded 20 daytime and seven night-time automated blood pressure measurements. Follow-ups occurred annually via phone or clinic visit, with total follow up ranging from two to seven years.

Researchers analyzed the rates of cardiovascular disease events, including heart attacks, strokes, heart failure and death, among the participants. The occurrence and timing of heart events in relation to blood pressure variations was analyzed to determine whether there were any associations.

In all, participants experienced a total of 306 cardiovascular events, including 119 strokes, 99 diagnoses of coronary artery disease, and 88 diagnoses of heart failure.

‘Significant, independent risk factor for cardiovascular events’

Authors say that an abnormal reading, or a systolic blood pressure measuring 20 mm Hg above a person’s daytime systolic reading, is significantly linked to the risk of atherosclerotic cardiovascular disease and heart failure. Similarly, participants with an abnormal circadian pattern, which occurs when sleep blood pressure exceeds daytime readings, were at particular risk of developing heart failure and had a greater risk of experiencing any heart disease event.

Excessive reduction of blood pressure during sleep may also be detrimental. Patients with well-controlled hypertension showed a significantly increased risk of stroke when nighttime systolic pressure took extreme dips.

“Results indicate that nighttime systolic blood pressure was a significant, independent risk factor for cardiovascular events,” says Kario. “The study highlights the importance of including nighttime blood pressure monitoring in patient management strategies and will hopefully encourage physicians to ensure that antihypertensive therapy is effectively lowering blood pressure throughout the 24-hour dosing period.”

But the authors note that their study is not without limitations.

Ambulatory data were obtained once at the start of the study. However, no information was available regarding the contributions of subsequent changes in ambulatory blood pressure levels up until the time of diagnosis of a cardiac event. The study also focused on systolic, rather than diastolic, measurements due to the older age of the participants.

The authors say study evaluations did not include echocardiograms, thus preventing some degree of differentiation for types of heart failure.

The new research is published in the American Heart Association’s flagship journal Circulation.

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Women who develop preeclampsia, a form of dangerously high blood pressure during pregnancy, are 5 times more likely to develop end-stage kidney disease later in life than women who have normal blood pressure during pregnancy, a Swedish study suggests.

Preeclampsia has long been linked to an increased risk of events like heart attacks and strokes years later, and some previous research also suggest that this form of high blood pressure might also be one reason why women are more likely to develop advanced kidney disease than men.

For the current study, researchers examined data on almost 2.67 million births among 1.37 million women between 1982 and 2012. A total of 67,273 women, or 4.9%, developed preeclampsia during at least one pregnancy, and 410 women developed end-stage kidney disease.

Women who had preeclampsia in two pregnancies were more than seven times more likely to develop end-stage kidney disease than mothers who never had preeclampsia, the study found.

“This study shows that pre-eclampsia is a sex-specific, independent risk factor for the subsequent development of end-stage kidney disease,” said lead study author Ali Khashan, a public health researcher at University College Cork in Ireland.

“However, the overall end-stage kidney disease risk remains small, and women with a history of preeclampsia should not be overly concerned,” Khashan said by email.

Women who develop preeclampsia earlier in pregnancy – before the halfway point – are more than nine times more likely to develop end-stage kidney disease than mothers with normal blood pressure during pregnancy.

The challenge with preeclampsia is that women often don’t experience symptoms until they have a life-threatening problem, especially when they’re otherwise healthy and have uncomplicated pregnancies.

Kidney failure, also called end-stage kidney disease, is most commonly caused by diabetes or high blood pressure. Other causes can include autoimmune diseases and genetic disorders or chronic urinary tract problems.

With kidney failure, people require an organ transplant or dialysis.

The connection between preeclampsia and kidney failure in the study persisted even after researchers accounted for other factors that can impact maternal health like age, education, and pre-pregnancy health problems like existing kidney disease or cardiovascular disease.

Women in the study who had preeclampsia were older on average and had a higher body mass index (BMI).

Among women with no preeclampsia in the first pregnancy, 14.2% were overweight and 4.9% were obese. Among women who did develop preeclampsia in their first pregnancy, 20.1% were overweight and 11.8% were obese.

The study wasn’t a controlled experiment designed to prove whether or how preeclampsia might lead to kidney failure later in life.

It’s possible that risk factors like obesity, high blood pressure, and diabetes contribute to both preeclampsia and kidney failure down the line, researchers note in PLoS Medicine. It’s also possible that some women who had preeclampsia might have had undiagnosed kidney problems at the time.

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A 55-year-old woman came in for an evaluation of ear drainage that has been going on for two to three years. She also reported getting “cross-eyed” when she presses her ear. She has a history of childhood ear surgery, and underwent two procedures within a one-year span about 20 years ago. Her ear examination showed that her tympanic membrane was intact and retracted. Fresh drainage was present in the ear canal. Palpation of the posterior ear canal wall showed that the medial aspect of the cartilaginous canal had a depression. Wet keratin debris was found after placing a loop curette in the deep area. Her audiogram showed a maximum conductive hearing loss. Her CT scan is on the right.
Diagnosis: Iatrogenic Cholesteatoma with Horizontal Canal Fistula
Many surgeons perform cholesteatoma surgery to remove the skin growth, make sure that no cholesteatoma remains, and reconstruct the ossicles. When dealing with patients with previous ear surgery (particularly two surgeries in quick succession), clinicians tend to presume that the surgery was for cholesteatoma. However, clinicians should thoroughly examine the ear of these patients. First, pay close attention to the post-auricular wound to determine if a previous mastoidectomy was performed. This helps rule out a mastoid fistula. Palpation of the wound may reveal a depression, which would likely correspond to a previous mastoidectomy. In children, the mastoid cortex tends to grow and close over time. Therefore, a depression may not always be palpated in a child who underwent a mastoidectomy.

Next, examine the tympanic membrane and pars tensa thoroughly. All debris should be removed from the tympanic membrane, preferably using a microscope and a small hook to separate the debris from the membrane. This is done to make sure that no perforations or new cholesteatomas are present. Keratin debris coming out of a cholesteatoma often appear as cerumen on the tympanic membrane. Using the term “wax on the TM” in patient charts, which is a common practice, should be avoided because cerumen-like debris on the tympanic membrane is highly suggestive of cholesteatoma. This debris needs to be removed for a full examination of the tympanic membrane. If it cannot be easily removed, ear drops can be applied to soften the debris and allow for suction.

Granulation tissue on the tympanic membrane or at the medial aspect of the canal should always be met with suspicion. Granulation, especially in the posterior superior quadrant or the pars flaccida area, should be considered as a possible sign of cholesteatoma. This condition causes an intense inflammatory reaction that may result in the development of granulation tissue. Since the pars flaccida area (superiorly) and the posterior superior quadrant are the most common areas of cholesteatoma development, any granulation tissue in those areas needs treatment and further workup to uncover the underlying cholesteatoma. Deep retractions are likely cholesteatomas that need further imaging workup, particularly if the patient experiences recurrent drainage. The depth of a retraction can be measured using an angled endoscope or a blunt angled 3 mm hook to palpate the depth of the retraction under microscopy. Check on the patient soon to make sure he or she does not get lost to follow-up.

Finally, the posterior canal wall needs to be evaluated from the tympanic membrane level to the meatus. This necessitates pulling the speculum out a bit to evaluate the lateral aspect of the canal. Since the debris in the ear canal can obscure a mastoid fistula, the posterior canal should be gently palpated with an angled curette to find any occult fistulas.

Horizontal nystagmus that occurs when pumping the tragus is a worrisome sign in a patient who has undergone previous surgery. The differential diagnosis of this phenomenon includes perilymph fistula or semicircular canal dehiscence. Traditionally called Hennebert’s sign, this condition was considered sign of perilymph fistula and has been associated with syphilitic ear disease during the pre-antibiotic era. Syphilis can cause destruction of the inner ear (otic capsule) bone and lead to canal dehiscence. Today, Hennebert’s sign is associated with superior canal dehiscence. However, the case of this patient was most suspicious for horizontal canal fistula caused by occult cholesteatoma. Examination of her CT scan showed an erosion of the horizontal canal anteriorly (Fig. 1). The large defect in the lateral canal wall and mastoid suggested a mastoid-canal fistula development, which is usually iatrogenic and caused by not straightening the lateral canal (Koerner) flap at the end of the surgery. In chronic ear surgery, an incision is generally made in the posterior ear canal skin so the tympanic membrane can be seen through the post-auricular wound. At the end of the surgery, these two flaps need to be straightened. If the tip of the lateral or medial canal flap is folded under, the folded skin can continue to grow and form an iatrogenic cholesteatoma, which can grow for many years before it is diagnosed.

The patient’s imaging showed a large defect in the mastoid (Figs. 2 and 3). It is unclear if the defect was from previous surgeries or from a canal-mastoid fistula or cholesteatoma. However, MRI imaging can help differentiate cholesteatoma from fluid, scar tissue, or other soft tissue. T2-weighted imaging can show if the tissue has high water content and appear brighter than the brain (Fig. 4). Cholesteatomas as small as 5 mm can be detected using axial (echoplanar) diffusion-weighted imaging (DWI). A non-echoplanar diffusion-weighted imaging sequence (a.k.a. HASTE sequence) can differentiate cholesteatomas as small as 3 mm. In this patient, the DWI sequence showed that the soft tissue in the mastoid was most likely a cholesteatoma (Fig. 5).

To treat a cholesteatoma that causes horizontal canal fistula, the fascia has to be removed and covered immediately. Ideally, the membranous canal is covered with the fascia, bone putty, and a thin Silastic® sheet, which is placed to prevent the adherence of other tissues (e.g., cartilage tissue). This way, the canal is less likely to get injured in any future ear surgery.

In some cases, the cholesteatoma may be strongly adherent to the membranous portion of the horizontal canal and cannot be separated without potentially injuring the membranous canal. Violating the membranous canal can cause deafness if inflammatory mediators or bacteria enter the perilymphatic space. Therefore, in these cases, the cholesteatoma is left on the membranous canal and exteriorized. This allows any keratin (dead skin) produced by the cholesteatoma to exit into the ear canal and not accumulate and cause more destruction. However, this leaves the patient with the same dizziness problem when pressure is place on the ear.

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High blood pressure is a condition that often happens with age and a person is deemed to have high blood pressure when they have a top reading (systolic pressure) higher than 140 and a bottom reading (diastolic pressure) higher than 90. You are more at risk of developing high blood pressure if you are overweight, have a family history of high blood pressure, are a heavy drinker, or have a poor diet and do no exercise. If left untreated, high blood pressure causes damage to the heart, arteries and kidneys, which further puts you at risk of possible sudden death from a stroke and heart attack.

If you have felt a strange numbing feeling or a slight paralysis, it is a major sign of high blood pressure and should not be ignored as it could be a sign you are at risk of having a stroke.

People have described a feeling of being paralysed on one side of their body or a complete numbness. This sudden numbness is a serious medical problem and is due to the disruption of blood flow to a part of the brain due to a lack of oxygen.

Blood pressure UK and The Stroke Association recommend using the FAST test to check whether you are having a stroke:

F – Facial weakness

Check if the person is smiling or if their mouth or eyes have drooped. Has the face fallen to one side.

A – Arm weakness

Can the arms be raised and can they stay there.

S – Speech problems

Is the speech slurred, can they understand what is being said and are they speaking clearly.

T – Time

Call 999 if any of these signs are detected.

Uncontrolled high blood pressure caused damage to blood vessels to the brain by becoming more narrow.

Over time, this raises the risk of a blood vessel bursting or being blocked. If blood cannot carry energy and oxygen to part of the brain due to this blocked or burst blood vessel, some cells in the brain may be damaged or even die.

This is known as a stroke and could lead to a permanent disability or even death.

It’s imperative to measure your blood pressure consistently and be aware of the major signs and symptoms of high blood pressure which include:

• Severe headaches
• Confusion and fatigue
• Vision problems
• Chest pain
• Irregular heartbeat
• Blood in urine
• Difficulty breathing

The NHS said: “The only way of knowing whether you have high blood pressure is to have a blood pressure test.

“All adults over 40 are advised to have their blood pressure checked at least every five years and getting this done is easy and could save your life.”

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High blood pressure, also known as hypertension, is a long-term medical condition which involves the blood pressure in the arteries which becomes persistently elevated. The symptoms of having high blood pressure are not obvious and if left untreated it puts a person at high risk of developing coronary heart disease, stroke, heart failure, vision loss, chronic kidney disease and dementia. A person’s evening toilet habit could be a sign of the condition and frequent trips to the loo at night could mean you are at risk of having high blood pressure. Needing to urinate at night every now and then should not be a cause for concern but if you are going to the loo every night, this could be a major sign of high blood pressure.

A study in Japan looked at 1,882 people who had an annual health check that included blood pressure measurements. Of the 1,882 participants 1,295 got up to pee at least once a night on average.

Researchers from the division of hypertension in Tohuku Rosai Hospital evaluated the association between high blood pressure and nocturia, a condition that causes frequent urinating at night.

This is compared to those who slept all night without going to the bathroom and those who got up to urinate at least once per night and were 1.4 times more likely to have high blood pressure.

Doctor Satoshi Konno of the division of hypertension at the Tohoku Rosai Hospital said: “Our study indicates that if you need to urinate in the night, called nocturia, you may have elevated blood pressure or excess fluid in your body.

“If you continue to have nocturia, ask your doctor to check your blood pressure and salt intake.”

The frequent need to go to the toilet at night not only disturbs one’s sleeping pattern but could also be a sign of a serious health condition.

Researchers believe the connection between getting up to urinate at night and high blood pressure is down to the dietary salt intake and previous studies have shown a diet high in salt is associated with having to urinate more at night.

There is a strong link between salt in the diet and high blood pressure.

Cutting back the salt intake in your diet could help lower your blood pressure, put you less at risk of developing serious health conditions and ensures a better night’s sleep. Foods such as ham, sausage, bacon, ancovies and pizza have a very high salt intake and you should try to avoid these types of foods.

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High blood pressure (also known as hypertension) is a common condition that can silently damage your body over time. One of the most serious complications is the thickening of the heart wall, especially the left side, known medically as left ventricular hypertrophy (LVH). Understanding this risk, and how to prevent it, is crucial for anyone living with or at risk for high blood pressure.

What Is High Blood Pressure?

Blood pressure is the force of your blood pushing against the walls of your arteries. A reading of 120/80 mmHg is considered normal. High blood pressure is usually defined as a reading consistently above 130/80 mmHg.

• Primary (essential) hypertension: No specific cause; related to genetics, lifestyle.
• Secondary hypertension: Caused by another condition (e.g., kidney disease, hormonal disorders).

Hypertension often has no symptoms, which is why it’s called the “silent killer.”

How Does High Blood Pressure Thicken the Heart Wall?

Your heart is a muscle that pumps blood. When blood pressure is high, your heart has to work harder to pump blood to your body. Over time, just like lifting heavy weights makes arm muscles bigger, this extra work causes the wall of the heart’s main pumping chamber (the left ventricle) to thicken. This is called left ventricular hypertrophy (LVH).

Why Is a Thickened Heart Wall Bad?

• Reduced pumping efficiency: The thickened muscle can become stiff and less able to fill with blood.
• Oxygen demand: A bigger heart muscle needs more oxygen, increasing the risk of angina (chest pain) and heart attacks.
• Electrical problems: Thickened muscle can disrupt the heart’s electrical system, causing arrhythmias (irregular heartbeats).
• Increased risk: People with LVH have a higher risk of heart failure, stroke, and sudden cardiac death.

Symptoms to Watch For

Many people have no symptoms at all, even with a thickened heart wall. If symptoms do develop, they may include:

• Shortness of breath, especially with activity
• Chest pain or pressure
• Irregular or rapid heartbeat (palpitations)
• Dizziness or fainting
• Fatigue, weakness

Note: These symptoms may signal advanced disease. Most people do not feel anything until the condition is serious.

How Is Heart Wall Thickening Diagnosed?

• Electrocardiogram (ECG/EKG): May show changes suggesting LVH.
• Echocardiogram (Heart Ultrasound): The best test. It measures the thickness of the heart walls and how well the heart pumps.
• MRI: Rarely used, but can give very detailed images.
• Routine check-ups: People with high blood pressure should have regular check-ups to monitor for complications.

Who Is Most at Risk?

• People with uncontrolled or long-standing high blood pressure
• Older adults (risk increases with age)
• People with kidney disease
• Those with a family history of heart disease
• People who smoke, are obese, eat a high-salt diet, or are physically inactive

How Can You Prevent Heart Wall Thickening?

The best prevention is to control your blood pressure! Here’s how:

1. Lifestyle Changes

• Eat a healthy, low-salt diet (such as the DASH or Mediterranean diet)
• Exercise regularly (at least 30 minutes most days)
• Maintain a healthy weight
• Limit alcohol and avoid smoking
• Manage stress (meditation, relaxation, hobbies)

2. Take Your Medications

If prescribed, take blood pressure medicines exactly as directed. Common medications include:

• ACE inhibitors
• ARBs
• Beta-blockers
• Calcium channel blockers
• Diuretics

Do not stop your medicine without talking to your doctor!

3. Regular Check-ups

• Monitor your blood pressure at home, if recommended
• Get regular doctor visits and heart check-ups
• Report any new symptoms immediately

What Should I Do If I Have High Blood Pressure?

1. Check your blood pressure regularly.
2. Follow your doctor’s treatment plan and keep all appointments.
3. Adopt heart-healthy habits (diet, exercise, avoid smoking/alcohol).
4. Know the warning signs of heart trouble (see symptoms above).
5. Talk to your doctor about getting an echocardiogram if you have long-standing or hard-to-control hypertension.

Summary Checklist

• Check your blood pressure regularly
• Take your medicines as prescribed
• Eat a low-salt, balanced diet
• Stay physically active
• Get regular heart check-ups
• Avoid smoking and limit alcohol
• Watch for symptoms, but remember LVH is often silent

When to Call Your Doctor

Contact your healthcare provider immediately if you experience:

• Chest pain or pressure
• Severe shortness of breath
• Fainting or severe dizziness
• Palpitations or irregular heartbeat

These could be signs of serious heart complications.

Final Words

High blood pressure can silently thicken your heart wall and raise your risk of heart attack, heart failure, and stroke. But with good management, regular check-ups, and heart-healthy habits, you can dramatically lower your risk and protect your heart for years to come.

Take charge of your blood pressure — your heart will thank you!

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