Why does smoking raise blood pressure?
How does nicotine cause high blood pressure?
It's obvious that smoking is bad for the lungs because of inhaling smoke. But why does it also affect blood pressure?
When you smoke, several mechanisms come into play that affect the blood pressure. Because nicotine, which is attached to tiny tar particles and absorbed through the lungs into the blood, can unlike many other toxins cross the bloodbrain barrier, it acts very quickly. In less than ten seconds the effect that smokers often feel as relaxing begins. This happens because the poison nicotine can bind to certain receptors in the brain and causes the release of various neurotransmitters. Its close proximity to the brain's reward center is a major factor in the development of addiction.
What matters for blood pressure is the resulting increase in heart rate and the immediate narrowing of the blood vessels. Both directly cause an increase in blood pressure. The heart has to pump more often and harder to reach the small, constricted blood vessels farthest away. Because the oxygen content of the blood is reduced, the body tries to maintain supply by speeding up the heartbeat. Also, the toxins from cigarettes cause small injuries to the innermost layer of the blood vessels. Deposits (arteriosclerosis) form and permanently narrow the vessels.
If you also consider the nicotine-increased tendency to form blood clots, it quickly becomes clear why smoking is one of the main risk factors for heart attacks, strokes or PAD (peripheral arterial occlusive disease) often also called smoker's leg or "window-shopper's disease." All of these conditions are caused by narrowing or blockage of blood vessels. The narrowing caused by nicotine-induced constriction and the deposits forming in the vessel can by themselves lead to a vessel becoming blocked. But if a clot is floating in the bloodstream, the chance that it will get stuck at a narrowing and block the vessel is much higher.
A study published in November 2023 also shows that smoking, even the seemingly less harmful puffing, changes the mouth's flora. There are naturally important bacteria in the mouth that make up the oral flora. Smoking reduces the bacteria that need oxygen to survive. These bacteria play a major role in converting dietary nitrate to nitrite and then to nitric oxide. Nitric oxide, in turn, plays a role in blood pressure regulation. Therefore smoking could negatively affect blood pressure in this way, but this needs further study.
A study published in November 2023 also shows that smoking, even the seemingly less harmful puffing, changes the mouth's flora. There are naturally important bacteria in the mouth that make up the oral flora. Smoking reduces the bacteria that need oxygen to survive. These bacteria play a major role in converting dietary nitrate to nitrite and then to nitric oxide. Nitric oxide, in turn, plays a role in blood pressure regulation. Therefore smoking could negatively affect blood pressure in this way, but this needs further study.
Smokers have a 65% higher risk of heart attack than non-smokers!
A lung disease caused by smoking COPD [chronic obstructive (= constricting) pulmonary disease] can lead to a dangerous increase in blood pressure in the pulmonary circulation (pulmonary arterial hypertension).
Even vaping e-cigarettes, often considered harmless, doesn't leave the body unaffected. Nicotine-containing liquids are especially controversial because the nicotine can affect blood pressure. Increased blood pressure and pulse, as well as greater arterial stiffness, have been observed after using a nicotine e-cigarette.
By the way: Secondhand smoke also increases the risk of developing high blood pressure. This especially affects children, who are forced into passive smoking by their parents' nicotine use. They often already suffer from elevated blood pressure in childhood.
Sources:
- http://rauchstoppzentrum.ch/0189fc92f10eee007/0189fc930310bda01/index.html
- https://www.rauchfrei-info.de/informieren/rauchen-gesundheit/herzkreislauferkrankungen/
- https://www.hochdruckliga.de/fileadmin/downloads/mitgliederbereich/downloads/broschueren/Empfehlungen_fuer_Betroffene.pdf
- https://academic.oup.com/ajh/article/20/6/637/183832?login=false
- https://www.nature.com/articles/s41598-023-42474-7
This article comes from BloodPressureDB – the leading app since 2011 that helps hundreds of thousands monitor their blood pressure every day.
Our content is based on carefully researched, evidence-based data and is continuously updated (as of 01/2024).
Author Sabine Croci is a qualified medical assistant with many years of experience in internal medicine and cardiology practices as well as in outpatient care, and has led BloodPressureDB's specialist editorial team since 2015. Thanks to her extensive additional qualifications as a paramedic, first responder and in various therapy and emergency areas, she provides solid, practical and reliably reviewed information.
Author Sabine Croci is a qualified medical assistant with many years of experience in internal medicine and cardiology practices as well as in outpatient care, and has led BloodPressureDB's specialist editorial team since 2015. Thanks to her extensive additional qualifications as a paramedic, first responder and in various therapy and emergency areas, she provides solid, practical and reliably reviewed information.
