Timing of smoking cessation and microcirculation parameters in young people suffering from hypertension stage I/II

The positive effect of smoking cessation has been proven by epidemiological studies. Changes in the microcirculation (MC), the most sensitive link in the cardiovascular system, in hypertensive patients who have quit smoking are of particular interest.

Objective. To evaluate the MC in young patients with stage I/II hypertension who have quit smoking depending on the duration of abstinence in comparison with those who continue to smoke.

Materials and methods. Young outpatients with stage I/II hypertension who have quit smoking (n=55) were examined – group 1. All were divided into 3 subgroups: 1.1. subgroup (n=16) – quit smoking for 1 month to 1 year inclusive, 1.2. subgroup (n=18) – quit smoking for 2 to 5 years, 1.3. subgroup (n=21) – 6 years and older. The comparison group consisted of smoking patients matched by age and gender (n=66) – group 2. All underwent outpatient examination according to the 2020 clinical guidelines for hypertension in adults. MC was studied by direct biomicroscopy of the bulbar conjunctiva. The average diameter of microvessels, the number of capillaries per 1 mm2 of the conjunctival surface, and the prevalence of intravascular red blood cell aggregation (RBCA) in four areas of the temporal region of the bulbar conjunctiva were assessed. The parameters of those who quit smoking were compared with smokers.

Results. In all subgroups of patients who quit smoking, the MC parameters differ significantly in the positive direction from those who continue to smoke, these highly reliable differences begin with 1.1. subgroups who quit smoking during the first year. The maximum prevalence of RBCA in all analyzed areas of the conjunctiva was found in the group of smoking hypertensive patients; with an increase in the abstinence period, there is a statistically significant decrease in RBCA with minimum values in the 1.2. subgroup with a subsequent increase in the 1.3. subgroup, who quit smoking 6 or more years ago.

Conclusions. In young patients with hypertension stages I/II who quit smoking, all analyzed parameters of the MC differ significantly in the positive direction compared to those who continue to smoke. Positive shifts in the MC were recorded in the 1.1. subgroup of those who quit smoking during the first year and persisted further with an increase in the abstinence period, which indicates the restoration of the endothelial function impaired by smoking, with a low smoking intensity and duration of hypertension at a young age.

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