High blood pressure and Cigarette smoking are the major precipitating factors for the cardiovascular events. The exact toxic components of cigarette smoke and the mechanisms involved in cigarette smoking related cardiovascular dysfunction are largely unknown. Various studies suggest that the coexistence of hypertension and smoking increases inflammation, thrombosis, oxidation of low-density lipoprotein cholesterol, oxidative stress and depletion of antioxidant. As oxidative stress is a potential mechanism for initiating cardiovascular dysfunction, this study was designed to compare the effect of smoking in biochemical parameters, non-enzymatic antioxidant status, lipid peroxidation product and lipid profile in Hypertensive smokers as compared to age-matched hypertensive non-smokers.Design and Method:
This cross sectional study was conducted among 205 hypertensive subjects from September 2015 to February 2016. Hypertensive smokers (n = 100) of age 36.2 ± 9.94 years and age-matched hypertensive controls (35.2 ± 4.73 years, n = 105) were interviewed with structured questionnaire. Serum vitamin E, vitamin C, albumin, bilirubin, uric acid, were measured by standard methods. Lipid profile [Total Cholesterol(TC), HDL cholesterol(HDLc), LDL cholesterol (LDLc) and Triacylglycerol(TAG) were measured and recently introduced predictive markers of plasma atherogenicity-“Risk ratio [TC/HDLc(RR)], Non HDL cholesterol[TC minus HDLc(NHC)] and Atherogenic index of plasma [log TAG/HDLc(AIP) were calculated]”. Serum malondialdehyde(MDA) level was estimated as a measure of lipid peroxidation.Results:
After adjusting the effect of age, dietary habit, alcohol consumption, blood glucose and duration of hypertension-Vitamin C, Vitamin E, and albumin were found to be decreased significantly and MDA level was increased significantly among hypertensive smokers as compared to hypertensive nonsmokers with p ≤ 0.005. Vitamin C and vitamin E showed inverse correlation with MDA, whereas MDA showed direct and significant positive correlation with TC, LDLc, RR, NHC and AIP.Conclusions:
These findings suggest that smoking induces oxidative stress, depleted antioxidants activities and subsequent alteration in circulating lipids in hypertension. Thus hypertensive smokers are more likely to develop severe forms of hypertension and Cardiovascular disease.