Key result
Smoking is linked to ~0.2-point lower reactive hyperemia index in hypertensive adults vs never-smokers.
Why the study?
Hypertension and smoking are established cardiovascular risk factors, and this study aimed to investigate the association between the reactive hyperemia index, a measure of endothelial function, and smoking among individuals with hypertension.
Cross-Sectional (n=1,485)
No
Current smoking is independently associated with impaired endothelial function, as measured by a lower reactive hyperemia index, in both normotensive and hypertensive individuals, particularly among males.
Answers are grounded in this paper and cite their sources.
Smoking associated with lower RHI in hypertensives; hypothesis-generating for endothelial effects, needs prospective confirmation.
Backgrounds Hypertension and smoking are established risk factors for cardiovascular disease. The reactive hyperemia index (RHI) reflects endothelial function. This study aimed to investigate the association between RHI and smoking among individuals with hypertension. Methods A total of 1,485 participants from a community were categorised into four groups according to hypertension status and smoking: group 1: normotensive never-smokers, group 2: normotensive current smokers, group 3: hypertensive never-smokers, group 4: hypertensive current smokers. RHI was measured using the Endo-PAT 2000 machine (Itamar Medical Ltd, Caesarea, Israel). Results Results showed that RHI was significantly lower in group 2 than in group 1 (1.78±0.50 vs 1.94±0.62, p<0.05), and significantly lower in group 4 than in group 3 (1.68±0.48 vs 1.91±0.60, p<0.05). RHI was also significantly lower in males than in females (1.79±0.48 vs 1.92±0.63, p<0.05). Smoking prevalence was significantly higher among males than among females. Age (t=-3.332, p<0.001; 95%CI[-0.013, -0.003]), fasting plasma glucose (t=-2.709, p=0.007; 95%CI[-0.037, -0.006]), total cholesterol (t=-2.503, p=0.012; 95%CI[-0.104, -0.013]), low-density lipoprotein cholesterol (t=2.639, p=0.008; 95%CI[0.020, 0.133]), homocysteine (t=1.972, p=0.049; 95%CI[2.830E-5, 0.011]), body mass index (t=-3.481, p=0.001; 95%CI[-0.027, -0.007]), systolic blood pressure (t=2.983, p=0.003; 95%CI[0.002, 0.007]), diastolic blood pressure (t=2.120, p=0.034; 95%CI[0.000, 0.006]), and smoking (t=-3.463, p=0.001; 95%CI[-0.290, -0.080]) were independently associated factors with RHI in all participants. Among males, systolic blood pressure (t=3.406, p=0.001; 95%CI[0.003, 0.012]) and smoking (t=-3.669, p<0.001; 95%CI[-0.278, -0.084]) remained independently associated with RHI. Conclusion RHI was significantly lower in participants with hypertension who were current smokers than in those who were never-smokers. Smoking was independently associated with RHI in all participants, particularly among males. Trial Registration http://www.chictr.org.cn/ (ChiCTR2000034085Registration date: June 23, 2020).
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Liu et al. (2026) conducted a cross-sectional in Hypertension (n=1,485). Current smoking vs. Never-smoking was evaluated on Reactive hyperemia index (RHI) in individuals with hypertension (β -0.185, 95% CI -0.290, -0.080, p=0.001). Current smoking was associated with significantly lower reactive hyperemia index in hypertensive adults compared with never-smokers (1.68 vs 1.91, p<0.05; adjusted β -0.185, p=0.001).
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