Low rates of detection and treatment of hypertension among current cigarette smokers

This report analysed data from the Health Survey for England 1994 to evaluate blood pressure (BP) management in relation to cigarette smoking. Data were analysed for 12013 adults aged greater than or equal to 16 years living in England in 1994. Among 2280 subjects with BID greater than or equal to 160/95 mm Hg or treated with BID-lowering medication, rates of awareness were 63% in never-smokers, 66% in ex-smokers and 51% in current smokers. After adjusting for age, sex, housing tenure, educational attainment, and systolic and diastolic BP, the relative odds of hypertension awareness for smokers, compared with never-smokers, were 0.63, 95% confidence interval 0.49 to 0.82, P <0.001. In the same group, the rates of BID treatment were 50% in never-smokers, 53% in ex-smokers and 36% in current smokers (odds ratio 0.64, 0.49 to 0.84, P=0.001). In 4500 subjects with BP greater than or equal to 140/90 mm Hg or treated, there was also strong evidence that current smokers were less likely to be aware of their high BP or treated. In this group, ex-smokers were more likely than never-smokers to be aware (odds ratio 1.23, 1.06 to 1.42, P=0.006) or treated for high BP (odds ratio 1.25, 1.06 to 1.47, P=0.009). Detection and treatment of high BP are particularly relevant in subjects who continue to smoke.