Hypertension is a powerful independent contributor to cardiovascular morbidity and mortality, on average conferring a threefold increase in risk at all ages and in both sexes Changes in clinical, biochemical and pathological variables characterize cardiovascular damage from smoking and hypertension when it acts independently . Smoking increases the risks of vascular damage by increasing sympathetic tone, platelet stickiness and reactivity, free radical production, damage to endothelium, and by surges in arterial pressure. Active smoking is a widely accepted risk factor for cardiovascular disease and is recognized as a major public health problem. Passive smoking, also known as Second-Hand Smoke Exposure (SHSE), is thought to have similar cardiovascular consequences and the risk has been postulated to be equivalent to that of active smoking. Smoking has a dose-dependent effect on periodontium. Poor periodontal health is associated with increased prevalence of hypertension and may have an influence on BP control. Risk factors such as older age, male gender, non-Caucasian ethnicity, smoking, overweight/obesity, diabetes, low socioeconomic status, and poor education have been considered the common denominators underpinning this relationship.