Smoking Cessation
Smoking has been shown to promote the acceleration of atherosclerotic disease and has been identified as one of the strongest risk factors in the development of peripheral artery disease. Smoking is related to a decreased rate of successful outcomes in vascular surgical interventions, an increased amputation rate, and an increased number of heart attacks and strokes. Smoking is also related to a decreased rate in survival of heart attack and stroke victims.
The effects of tobacco include:
- Constriction of blood vessels (as blood vessels become smaller, the blood pressure is raised)
- Increased carbon monoxide levels in the bloodstream, which impairs oxygen transport
- Formation of blood clots
- Acceleration of the process of atherosclerosis
- Increased risk of blockage in leg arteries (there is a 30 percent to 50 percent increase with smoking one-half pack per day)
- Cause of heart attacks, strokes, and/or death
- Decreased chance of successful surgical outcome
- Greater risk for amputation
Smoking cessation has been shown to decrease the progression of the atherosclerotic process. Current guidelines advise all smokers to quit. If you are unable to quit smoking, your physician may refer you to a specialist. A specialist may recommend educational materials, behavior modification counseling, medications, and follow-up care. Cessation interventions may also include support groups or individual counseling, learning new coping skills, sessions with a specialist for a prescribed period of time, and/ or nicotine replacement therapy (NRT). Specific instruction should be included if nicotine replacement therapy is started. Non-nicotine medications may also be used as an alternative or in addition to other therapies.
Steps to smoking cessation include:
- Dispose of all cigarettes and ash trays before you quit.
- Seek family and friends for support.
- Avoid social situations which stimulate desire for smoking (drinking alcohol).
- Ask your physician for referral to a specialist for smoking cessation.
Most insurance plans cover medications and services for smoking cessation. In some states, Medicaid will also include coverage for medications.
In addition, weight gain has been shown to be minimal after one year of smoking cessation. The benefits of quitting smoking outweigh the effects of weight gain.
Gigh blood pressure (hypertension): High blood pressure affects the structure of the wall of the artery, accelerating the rate at which atherosclerosis develops.
According to the National Heart, Lung, and Blood Institute (NHLBI) of the National Institutes of Health (NIH), high blood pressure for adults is defined as:
- 140 mm Hg or greater systolic pressure and
- 90 mm Hg or greater diastolic pressure
In an update of NHLBI guidelines for hypertension in 2003, a new blood pressure category was added called prehypertension:
- 120 mm Hg - 139 mm Hg systolic pressure and
- 80 mm Hg - 89 mm Hg diastolic pressure
The new NHLBI guidelines now define normal blood pressure as follows:
- Less than 120 mm Hg systolic pressure and
- Less than 80 mm Hg diastolic pressure
These numbers should be used as a guide only. A single elevated blood pressure measurement is not necessarily an indication of a problem. Your physician will want to see multiple blood pressure measurements over several days or weeks before making a diagnosis of hypertension (high blood pressure) and initiating treatment. A person who normally runs a lower-than-usual blood pressure may be considered hypertensive with lower blood pressure measurements than 140/90.
Weight loss, regular physical exercise, and balanced diet has shown to be effective in lowering high blood pressure. A weight loss of about five percent of total body weight may lower the blood pressure and cause blood pressure medications to be more effective. Exercise for approximately 30 to 45 minutes (such as brisk walking) on most days of the week has been shown to decrease blood pressure.
Blood pressure medications may be used to help control elevated blood pressure. Your physician will prescribe the appropriate medication(s) for your situation. There are several types of medications which act in different ways to lower blood pressure.
