The Blood Pressure of Hypertensive Smokers
Results suggest that the ambulatory systolic BP of smokers may be considerably higher than that of nonsmokers while office BPs appear remarkably similar, which should be interpreted cautiously given a number of methodologic concerns.
Abstract
To the Editor. —The report by Mann et al 1 provides intriguing results that suggest that the ambulatory systolic BP of smokers may be considerably higher than that of nonsmokers while office BPs appear remarkably similar. Those provocative findings should be interpreted cautiously given a number of methodologic concerns. First, it should be emphasized that smokers differed substantially from nonsmokers by age and, to a lesser extent, by race. Such differences in measured variables raise the possibility that the smokers and nonsmokers differed as well in terms of other important characteristics, measured or unmeasured, which potentially may confound the apparent association between smoking and ambulatory systolic BP (eg, alcohol intake). Second, in the stratified analyses, the authors "split" the matched sets of nonsmokers and smokers, originally assembled in a 2:1 ratio. As such, it appears that 20 of the nonsmokers who had been matched to smokers less than 50 years