Smoking is Associated with Dose-Related Increase of Intima-Media Thickness and Endothelial Dysfunction

• Published in: Angiology 1999-03, Vol.50 (3), p.201-208
• Main Authors: Poredoš, Pavel, Orehek, Marta, Tratnik, Erika
• Format: Article
• Language: English
• Subjects: Adult; Age Factors; Arteriosclerosis - etiology; Biological and medical sciences; Body Mass Index; Brachial Artery - diagnostic imaging; Brachial Artery - pathology; Brachial Artery - physiopathology; Carotid Arteries - diagnostic imaging; Carotid Arteries - pathology; Carotid Arteries - physiopathology; Cholesterol - blood; Cholesterol, LDL - blood; Endothelium, Vascular - physiopathology; Female; Fibrinogen - analysis; Humans; Hyperemia - diagnostic imaging; Hyperemia - pathology; Hyperemia - physiopathology; Lipoprotein(a) - blood; Male; Medical sciences; Multivariate Analysis; Regional Blood Flow - physiology; Rest - physiology; Risk Factors; Sex Factors; Smoking - adverse effects; Smoking - blood; Smoking - pathology; Smoking - physiopathology; Time Factors; Tobacco, tobacco smoking; Toxicology; Tunica Intima - pathology; Tunica Media - pathology; Ultrasonography; Vasodilation - physiology
• ISSN: 0003-3197; 1940-1574
• DOI: 10.1177/000331979905000304

Cigarette smoking is firmly established as a risk factor for atherosclerosis. However, the exact mechanism causing smoking-related damage to the arterial wall and its relation to the atherosclerotic process is not known. Also unknown is the time delay between the start of smoking and the sequence of functional and morphologic changes occurring in the arterial wall caused by smoking and their interrelationship. Therefore, the aim of this study was to evaluate the acute and chronic effects of smoking on endothelium- dependent (flow-mediated) dilation (FMD) of the peripheral arteries, the effects of dose and duration of chronic smoking on intima-media thickness (IMT) of the carotid arteries, and their interrelationship. The study encompassed two groups of smokers. In group A there were 40 subjects of both sexes, who smoked on average 17.6 ±6.5 cigarettes per day, for 5 to 15 years (mean 8.95 ±4.0 years), mean age 28.1 years. Group B consisted of 42 smokers of both sexes who smoked 21.15 ±8.2 cigarettes/day for more than 15 years (mean 21.15 ±3.4 years), mean age 39.5 years. The control group consisted of 40 healthy subjects without major risk factors of atherosclerosis, mean age 29.1 years. By means of high-resolution ultrasound the brachial artery diameter was measured at rest and during reactive hyperemia (after release of a forearm tourniquet) and the flow- mediated, endothelium-dependent dilation was calculated. (continued on next page) The IMT of the carotid arteries was determined in all subjects by use of B-mode ultra sonography. Resting blood flow in the brachial arteries was significantly less in the smokers' groups than in controls (78.8 ±31.9 vs 134.9 ±45.0 mL/min, p