Keywords
How to Cite
Abstract
The aim of the study. To study the influence of smoking cessation on the peculiarities of blood pressure (BP) regulation in the dynamics of cardiorehabilitation treatment in patients after acute coronary syndrome (ACS). Materials and methods. 124 patients who underwent a cardiorehabilitation program in the rehabilitation department after heart disease after a recent ACS were examined. Depending on the smoking habit, all patients were divided into two groups. The first (I) group included patients with the smoking factor (smokers, n=68, average age 56.70±6.1 years), the second (II) group — patients without the smoking factor (non-smokers, average age 58,29±5.37 years). At the end of the sanatorium-resort rehabilitation, to assess the dynamics of the studied indicators, group I was divided into two subgroups: IA — smokers (n=38) who gave up smoking during the CR process, and IB — smokers (n=30) who continued to smoke. In the patients of the studied groups, the main indicators of daily blood pressure monitoring (DMBP) were determined The results. The analysis of the dynamics of blood pressure regulation indicators showed that in the subgroup of smokers who quit smoking (IA), the most pronounced positive dynamics of such indicators as average daily levels of heart rate (HR) (-14.8% (IA) versus -10.8% (IB) and -10 .3% (II)), SBP variability (-12.8% (IA) vs. -6.9% (IB) and -11.1% (II)) and DBT (-19.2% (IA) vs. -6.3% (IB) and -10.2% (II)) and levels of morning rise SBP (-20.8% (IA) vs. -5.7% (IB) and -16% (II)) and DBP (-28.9% (IA) vs. -8.2% (IB) and -19.5% (II)). It was established that in persistent smokers, there is no significant reduction and achievement of target values of similar indicators of DMBP against the background of undergoing a physical training program. Conclusions. Quitting smoking leads to a significant improvement of the daily blood pressure profile at the stage of cardiorehabilitation treatment of patients after ACS. Thus, smoking cessation should be a mandatory controlled component of recovery treatment programs to reduce the risk of recurrent cardiovascular events in such patients.
References
Savage DD, Garrison MS, Kannel WB, Levy D, Anderson SJ, Stokes J [et al.]. The spectum of left ventricular hypertrophy in a general population sample Framingam Study. Circulation. 1987;75:1-26.
Следзевська ІК, Бабій ЛМ, Липовецький АМ. Оптимізація артеріального тиску в період реабілітації у хворих з інфарктом міокарда і супутньою артеріальною гіпертензією. Укр. кардіол. журн. 2006;3:20-23.
McEvoy JW, Jennings C, Kotseva K, Backer GD, De Bacquer D, Ryden L [et al.]. EUROASPIRE II Investigators. Lifestyle and risk factor management and use of drug therapies in coronary patients from 15 countries: principal results from EUROASPIRE II Euro heart survey programme. Eur Heart J. 2001;22:554-72.
Amar J, Chamontin В, Ferrieres J, Danchin N, Grenier O, Cantet C [et al.]. Hypertension control at hospital discharge after acute coronary event: influence on cardiovascular prognosis — the PREVENIR study. Heart. 2002;88:587-91.
Johnson HM, Gossett LK, Piper ME, Aeschlimann SE, Korcarz CE, Baker TB [et al.]. Effects of smoking and smoking cessation on endothelial function: 1-year outcomes from a randomized clinical trial. J Am Coll Cardiol. 2010;55(18):1988-95.
Otsuka R, Watanabe H, Hirata K, Tokai K. Acute effects of passive smoking on the coronary circulation in healthy young adults. JAMA. 2001;286:436-441.
Markus MR, Stritzke J, Baumeister SE, Siewert U, Baulmann J, Hannemann A [et al.]. Effects of smoking on arterial distensibility, central aortic pressures and left ventricular mass. Int J Cardiol. 2013;168:2593-601.
Morillo MG, Moraes Amato MC, Cendon Filha SP. Twenty-four hour blood pressure record for smokers and nonsmorers. Arq. Bras. Cardiol. 2006;87(4):504-11.
Virdis АА, Giannarelli C, Neves MF, Taddei S, Ghiadoni L. Cigarette Smoking and Hypertension. Curr Pharm Des. 2010;16(23):2518-25.
Alomari MA, Khabour OF, Alzoubi КН, Shqair DM, Eissenberg T. Central and peripheral cardiovascular changes immediately after waterpipe smoking. Inhal Toxicol. 2014;26(10):579-87.
Al-Safi SA. Does Smoking Affect Blood Pressure and Heart Rate? Eur J Cardiovasc Nurs.2005;4(4):286-9.
Otsuka R, Watanabe H, Hirata K, Tokai K. Acute effects of passive smoking on the coronary circulation in healthy young adults. JAMA. 2001;286:436-441.
Li G, Wang H, Wang K, Wang W, Dong F. The association between smoking and blood pressure in men: a cross-sectional study. BMC Public Health. 2017;17 (1):797.
Giallauria F, De Lorenzo A, Pilerci F, Manakos A, Lucci R, Psaroudaki M [et al.]. Reduction of N terminal-pro-brain (B-type) natriuretic peptide levels with exercise-based cardiac rehabilitation in patients with left ventricular dysfunction after myocardial infarction. Eur J Cardiovasc Prev Rehabil.2006;13(4):625-632.
Linneberg A, Jacobsen RK, Skaaby T, Taylor AE, Fluharty ME, Jeppesen JL [et al.]. Effect of Smoking on Blood Pressure and Resting Heart Rate: A Mendelian Randomization Meta-Analysis in the CARTA Consortium. Circ Cardiovasc Genet. 2015;8(6):832-41.