IS CIGARETTE-SMOKING AN EFFECT MODIFIER OF THE RELATION BETWEEN ANTIHYPERTENSIVE THERAPY AND BLOOD-LIPIDS

We examined the relation between current use of antihypertensive medic ations and lipid levels in relation to smoking status. We used data fr om cross-sectional random sample surveys conducted between 1981 and 19 93 in two southeastern New England communities. The analysis included 3,027 normotensive, 1,416 untreated hypertensive, and 1,174 treated hy pertensive survey respondents between 40 and 64 years of age. After ad justment for body mass index, diabetes mellitus, alcohol use, use of m edications with adverse lipid effects, age, and sex, the estimated mea n high-density-lipoprotein cholesterol level among hypertensives using beta-blockers [44.6 mg per dl; 95% confidence interval (CI) = 43.1-46 .1] was lower than that for either untreated hypertensives (48.5 mg pe r dl; 95% CI = 47.8-49.2) or normotensives (47.1 mg per dl; 95% CI = 4 6.6-47.6). This pattern was similar among smokers and nonsmokers. Smok ers treated with beta-blockers, however, had particularly low levels o f high-density-lipoprotein-cholesterol (43.4 mg per dl; 95% CI = 40.7- 46.1), compared with non-smokers using beta-blockers (45.8 mg per dl; 95% CI = 44.2-47.3). Low levels of high density-lipoprotein-cholestero l may increase the risk of coronary heart disease among smokers using beta-blockers.