Ayed Mizher Habeeb Al-Shammari1*, Ian Naylor2, Robert Naylor2
1. P.O.Box 2611 code 01028 Al- Jahra Center, Kuwait. 2. School of Pharmacy University of Bradford, Bradford, West Yorkshire, United Kingdom
Keywords: Smoker, diastolic blood pressure, aspirin, Nicotine

Smoking promotes arthrosclerosis which means hardening of blood vessels and blocking of arterioles. When this affects the blood vessels that supply the heart, it can lead to destruction of heart muscle. To try and find out why the aspirin had exerted such a beneficial effect, some of the major risk factors which contribute to the risk of heart attacks and strokes were examined in the subjects who took part in the trial, and they all were smokers. It has been observed that diastolic pressure had been modified during the treatment with aspirin.

Article Information

Identifiers and Pagination:
First Page:212
Last Page:215
Publisher Id:JAppPharm (2012 ). 4. 212-215
Article History:
Received:April 27, 2012
Accepted:June 20, 2012
Collection year:2012
First Published:October 1, 2012


Stimulation of production hormone, epinephrine (also known as adrenaline), in the adrenal gland.That raises blood pressure because of nicotine which constricting blood vessels, due to reduction of oxygen in blood. [1]

Carbon monoxide which is one of important component of smoke is considered a lethal gas. Oxyhemoglobin are form by interferes between carbon monoxide from smoke and oxygen which has been breathed in attach to the hemoglobin, the oxyhemoglobin are necessary for the tissues of the heart and organs. [2] After delivering the oxygen to respective place, hemoglobin is again available for carrying oxygen. Carbon monoxide then attaches itself to haemoglobin instead of the oxygen and death can eventually occur because of oxygen starvation.

The most important aspect about elimination of nicotine it is excretion depending on pH.

The excretion of urine is reduced depending on the pH of the urine when urine alkaline and the urine increase when urine acidic.

Lactating women who smoke nicotine it is excreted in their milk, the nicotine in mammary milk smoker may contain 0.5 mg/liter nicotine in milk. [3]

Nicotine acts as a centre for clumping the platelets and develops high pressure of blood and aspirin was found for dissolving such clots. [4]

Aspirin inhibit the production of thromboxane which causes antiplatelet effect. In present research the patient who smoke nicotine and have developed high blood pressure were treated with aspirin.

The platelet molecules under normal circumstances bind together to repair the damage blood vessels. That is the reason to use aspirin for long term with low dose to prevent heart attacks, strokes, and blood clot formation in people with high risk of developing blood clot. It has been establish that dose of aspirin (low dose) to be given immediately after a heart attack to reduce the risk of another heart attack or the death of cardiac tissue. [5]



To examine the effect of aspirin over the whole range of diastolic blood pressures, the patients (n= 150) were placed into three groups made according to their limits of diastolic blood pressure. This rather arbitrary grouping was not expected to produce identical numbers in each group but was rather to make comparisons between non–aspirin treated and aspirin treated patients more comparable – in terms of one factor – diastolic pressure. Total numbers of 192 patients were considered under observation that has developed Diastolic blood pressure. After keen observation the patients who were smoker and have diastolic blood pressure were sorted out and that number was found to be 152. Whole patients were divided into three groups on the basis of their diastolic blood pressure. Out of 56, 35 patients who were smokers were kept in first group with diastolic blood pressure greater and equal to 70mmg Hg. In second group 40 out of 57 patients were treated with aspirin and their blood pressure range was considered of 70 to 80mm Hg. In third group 77 patients out of 79 were provided aspirin treatment and their diastolic blood pressure was considered equivalent and greater than 80mm Hg. 

At high doses, aspirin may cause false-positive results for urinary glucose if using the cupric sulfate method (Benedict’s solution) and false-negative results if using the glucose oxidase method (Tes-Tape). Urinary ketones measured by the ferric chloride method (Gerhardt) were affected when salicy­lates are in the urine (reddish-color produced). 5-HIAA determinations by the fluoremetric method may be interfered by salicylates in the urine. Falsely elevated VMA (vanillylmandelic acid) had been seen with most methods used if salicylates are in the urine. Falsely lowered VMA levels may be seen if using the Pisano method. Urinary excretion of xylose may be decreased if aspirin is given concurrently. Falsely elevated serum uric acid values were measured by using colorimetric methods. [6]



192 patients were admitted who have diastolic blood pressure problems but out of 192 patients only 152 were smokers and their diastolic blood pressure were normalized by aspirin treatment successfully. To cover whole range of diastolic blood pressure, the patients were grouping according to that limit of diastolic blood pressure. Out  of 56 patients 35 were those patients who were smoker and their blood pressure were 70mm Hg and most of them were the patients of hypertension to cover their hypertension they smoked and their diastolic blood pressure is disturbed and they were benefited with aspirin treatment , while remaining[56-35=21] have this problems but not because of smoking. The other group of patients who having their diastolic blood pressure problem lying between 70mmHg to 80 mm Hg, in this group of patients’ only 40 patients were cured with aspirin treatment where as total patients of this group who were admitted to hospital was 57. The obtained results are comprehensively summarized in the Table 1 and Figure 1 as under;


Table 1.  The distribution of patients into three ‘levels of diastolic pressures’, and the numbers treated by aspirin (75mg/day for x months). The difference between the total number of patients and the treated group are those that received placebo preparations.

Diastolic blood pressure

(mm Hg)

Total patients

(n= 192)

Aspirin treated

(n= 152)

Relative risk (to show the benefit of aspirin treatment)














Figure 1. Bar chart of the numbers of subjects in each group as defined by their diastolic pressures = 70mmHg, 70-80 mmHg and = 80mmHg. The number of subjects who received either aspirin (the blue block) or non aspirin treated (the pink block) for each of the three diastolic pressure groups which were studied. The aspirin treated groups received 75mg which was given for 7 days.


While; the patients who have diastolic blood pressure greater than 80mm Hg these patients have been categorized due to its severity as Stage#1hypertension and Stage#2hypertension,it has been found that 77 patients with this range of diastolic blood pressure out of 79 have been cured with aspirin treatment, it means that  effectiveness of aspirin increases with the increase in diastolic blood pressure and aspirin can control the greater rise of diastolic pressure in better way.



From this data it can be seen that the relative risk is favorable for aspirin therapy at all levels of diastolic pressure. It could be argued that the first two diastolic levels are more successful than the third levels, namely over 80mmHg. Again this may be possible to explain as these patients have usually had cardiovascular disease for a longer period of time and the reversal of long standing problems may be simply too great for the aspirin to overcome. After observing such improvement these patients were followed up for the next 30 days and after that aspirin is suggested on a regular basis and they were advised to continue use low dose of aspirin.



All aspects of this study were read by and approved by authorities in Kuwait who give ethical approval for such studies to be undertaken. I am extremely grateful for pharmacy and nursing staff in the Ministry of health (Chest hospital) in the state of Kuwait for being patient and kind when I was collecting the relevant data.



  1. Terry Martin, (2008) “ Nicotine’s Effects on the Brain” Health’s Disease and Condition.
  2. Lunell E. Molander L. Ekbergk, Wahren J. (2004) “Site of nicotine absorption from vapour inhaler.” “Europeon J. of clinical Pharmacology.” P.737-741
  3. Parrott, A., Morinan, A., Moss, M. and Scholey, A. (2004) Understanding Drugs and behaviour, Part II, Section 5 - Nicotine and cigarette smoking, pp 55-70, John Wiley and Sons, West Sussex, England
  4. Randall S. Stafford. (2000)” Aspirin use in low among U.S. out patients with coronary artery disease” “American Heart Association” Circulation, 101:1097-1101.
  5. Michael G.J; Jo Ann E.M.; Paul M.R. “Primary and secondary prevention of coronary heart disease”8th Ed page 1057-1084, 2007.
  6. Caraway, WT and Kammeyers, C.W. (1972) Chemical interference by drugs and othersubstances with clinical laboratory test. Clinical Chemistry Acta, 41, pp.395-494.

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Prof. Dr. Cornelia M. Keck (Philipps-Universität Marburg)
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Welcome to the research group of Prof. Dr. Cornelia M. Keck in Marburg. Cornelia M. Keck is a pharmacist and obtained her PhD in 2006 from the Freie Universität (FU) in Berlin. In 2009 she was appointed as Adjunct Professor for Pharmaceutical and Nutritional Nanotechnology at the University Putra Malaysia (UPM) and in 2011 she obtained her Venia legendi (Habilitation) at the Freie Universität Berlin and was appointed as a Professor for Pharmacology and Pharmaceutics at the University of Applied Sciences Kaiserslautern. Since 2016 she is Professor of Pharmaceutics and Biopharmaceutics at the Philipps-Universität Marburg. Her field of research is the development and characterization of innovative nanocarriers for improved delivery of poorly soluble actives for healthcare and cosmetics. Prof. Keck is executive board member of the German Association of Nanotechnology (Deutscher Verband Nanotechnologie), Vize-chairman of the unit „Dermocosmetics“ at the German Society of Dermopharmacy, active member in many pharmaceutical societies and member of the BfR Committee for Cosmetics at the Federal Institute for Risk Assessment (BfR).

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