Tobacco smoking is a major modifiable risk factor for cardiovascular disease, affecting blood pressure & arterial health. It reviews how cigarette smoking interacts with hypertension causing immediate hemodynamic changes, chronic vascular damage & increased cardiovascular risk through mechanisms like sympathetic activation,endothelial dysfunction, oxidative stress& atherosclerosis Smoking combined with hypertension sharply raises the risk of myocardial infarction, stroke & renal failure. The most effective intervention for hypertensive smokers is cessation, which improves vascular recovery