Smoking and hypertension: what should you know?

Nicotine can narrow blood vessels and stimulate the heart, while other smoke chemicals injure artery walls. Hypertension places additional pressure on those vessels. The combination can contribute to heart, kidney, and blood-vessel disease, including [Heart Failure](/conditions/heart-failure/), [Chronic Kidney Disease](/conditions/chronic-kidney-disease/), and [Stroke](/conditions/stroke/). Hypertension may have no obvious symptoms, so feeling well does not confirm that blood pressure is controlled.

Have your blood pressure checked using a validated monitor and record readings in the way your clinician recommends. Do not smoke shortly before a reading, because recent nicotine can affect the result. Discuss a quit plan, including support for cravings and withdrawal. Take prescribed blood-pressure medicine regularly; do not change it without advice. Regular movement, less salty processed food, sensible alcohol choices, restorative sleep, and weight management can complement treatment. [Obesity](/conditions/obesity/) and [Obstructive Sleep Apnoea](/conditions/obstructive-sleep-apnoea/) may also affect blood pressure.

Seek emergency help for severe chest pain, severe breathlessness, fainting, sudden weakness on one side, facial drooping, trouble speaking, or sudden vision loss. These symptoms can occur with [Angina](/conditions/angina/), [Stroke](/conditions/stroke/), or a [Transient Ischaemic Attack](/conditions/transient-ischaemic-attack/) and should not be explained away as a smoking effect. Contact your clinician if home readings remain unusually high or you develop recurring headaches with visual symptoms.

Ask how to measure at home, what readings need urgent advice, which quit-smoking treatment is safe with your medicines, and whether you need checks for kidney, heart, or vascular complications. Mention snoring, pauses in breathing, or daytime sleepiness.