Can Nicotine Raise Your Blood Pressure?

It’s no secret that smoking affects heart health. In fact, experts think that up to 30% of coronary heart disease deaths each year are due to smoking. While there are numerous substances in tobacco products that affect the heart, nicotine has the strongest link to cardiovascular disease. 

Nicotine isn’t just found in cigarettes, it’s also found in vapes, e-cigarettes, smokeless tobacco, and nicotine replacement therapy (NRT). Nicotine can affect heart health by raising blood pressure, causing changes in heart rate, and damaging the lining of blood vessels. 

Read on to learn more about the relationship between nicotine and blood pressure and nicotine’s other effects on heart health.        

Does nicotine raise blood pressure?

Yes, nicotine raises blood pressure. There are a few ways that nicotine increases blood pressure. Nicotine: 

• Increases stress hormones

• Makes the heart beat faster

• Constricts (narrows) the blood vessels outside the heart  

These changes raise your blood pressure.

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How much does nicotine raise your blood pressure?

The average increase in blood pressure from nicotine appears to be between 5 mm Hg and 10 mm Hg. 

But exactly how much nicotine raises blood pressure depends, in part, on whether you have high blood pressure to begin with. Nicotine has a more pronounced effect on people who already have high blood pressure. So you may see more than a 10 mm Hg change in your blood pressure after smoking if you have hypertension. 

The other factor that can affect how much nicotine raises blood pressure is the type of nicotine product you use. 

Smoking nicotine affects blood pressure the most. This includes consuming nicotine through cigarettes, e-cigarettes, and vapes. Smokeless tobacco products have less of an effect on blood pressure. And nicotine replacement products (like a nicotine patch, gum, or lozenge) affect blood pressure the least. 

How quickly can nicotine affect blood pressure?

Nicotine can increase your blood pressure fast. One study of cigarette smokers found blood pressure increased within about 10 minutes of nicotine exposure.

Increases in blood pressure are usually short term. However people who use nicotine regularly have higher daily average blood pressures.

How else does nicotine affect your heart health?

Cigarettes and other tobacco products have many ingredients besides nicotine that can affect the heart. That’s why experts trying to look at the effects of nicotine alone have studied NRT and e-cigarettes. In these products, nicotine is the primary ingredient that appears to affect heart health. 

Let’s look at what the evidence tells us about how nicotine can affect your cardiovascular health.

Heart attack

Nicotine increases the risk of heart attack. This may partly be due to the fact that nicotine negatively affects the time between heartbeats or heart rate variability (HRV). HRV is a measure of heart health. Abnormal HRV is a known risk factor for heart attacks and sudden death. 

Heart failure

Smoking has been shown to increase the risk of heart failure. One animal study found that nicotine increased fibrosis (scarring) of the heart muscle. Over time, fibrosis can lead to a change in heart size or shape that affects its ability to pump blood.

Atherosclerosis and blood vessel damage

Nicotine can increase oxidative stress, a process in which toxins called free radicals damage cells. When this damage happens to the lining of blood vessels, people risk developing atherosclerosis or hardening of the arteries. Damage to the lining of the aorta, the largest artery in the body, can also put people at risk for developing abdominal aneurysms, which can suddenly burst. Abdominal aneurysms are often fatal when they burst.

Arrhythmias

Researchers have found that nicotine can trigger abnormal heart rhythms or arrhythmias. Nicotine may trigger these abnormal heartbeats by causing the release of stress hormones called catecholamines or by blocking specific electrolyte channels. 

Circulation

Nicotine constricts (tightens) blood vessels both inside and outside of the heart. This narrowing limits blood flow to the heart and other tissues, including the skin, legs, and feet. That’s how nicotine increases the risk for problems in both the coronary arteries (blood vessels to the heart) as well as peripheral arteries (blood vessels to the rest of the body).   

How can you reduce the effects of nicotine on your blood pressure?

The best way to reduce nicotine’s effect on your blood pressure is to cut back or quit smoking and using other tobacco products. That can be hard to do, especially if you’ve used tobacco products for a long time. 

But there are resources to help you stop smoking, including:

• Medication-assisted therapy: Medication-assisted therapy includes prescription medicines like bupropion (Wellbutrin) and varenicline (Chantix).  

• NRT: These products provide a controlled dose of nicotine to reduce cravings as you quit using tobacco. E-cigarettes and NRT have less negative effects on heart health than smoking. 

• Support groups and programs: Support groups and smoking cessation programs can help you on your journey to stop smoking and using tobacco products.

How long does it take for blood pressure to go back to normal after you stop smoking?

Nicotine raises your blood pressure quickly. Fortunately, your blood pressure and heart rate will also drop quickly once you stop smoking. 

The American Heart Association (AHA) notes that your blood pressure can drop as soon as 20 minutes after you stop smoking. 

And researchers have found more pronounced drops in blood pressure in people who smoked and have a history of high blood pressure compared with people who smoked but didn’t have any chronic blood pressure issues.  

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Written by:

Brian Clista, MD

Dr. Clista is a board-certified pediatrician who works in private practice in Pittsburgh, Pennsylvania. He previously served as a National Health Service Corporation Scholar in the inner city of Pittsburgh for 11 years.

Edited by:

Patricia Pinto-Garcia, MD, MPH

Patricia Pinto-Garcia, MD, MPH, is a medical editor at GoodRx. She is a licensed, board-certified pediatrician with more than a decade of experience in academic medicine.

Reviewed by:

Christine Giordano, MD

Christine Giordano, MD, is board-certified in general internal medicine. She received her medical degree from Rutgers New Jersey Medical School and completed residency at Thomas Jefferson University.

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