title: Cardiovascular effects of secondhand smoke: nearly as large as smoking.
abstract: BACKGROUND
  Secondhand smoke increases the risk of coronary heart disease by approximately 30%. This effect is larger than one would expect on the basis of the risks associated with active smoking and the relative doses of tobacco smoke delivered to smokers and nonsmokers.
  
  
  RESULTS
  We conducted a literature review of the research describing the mechanistic effects of secondhand smoke on the cardiovascular system, emphasizing research published since 1995, and compared the effects of secondhand smoke with the effects of active smoking. Evidence is rapidly accumulating that the cardiovascular system--platelet and endothelial function, arterial stiffness, atherosclerosis, oxidative stress, inflammation, heart rate variability, energy metabolism, and increased infarct size--is exquisitely sensitive to the toxins in secondhand smoke. The effects of even brief (minutes to hours) passive smoking are often nearly as large (averaging 80% to 90%) as chronic active smoking.
  
  
  CONCLUSIONS
  The effects of secondhand smoke are substantial and rapid, explaining the relatively large risks that have been reported in epidemiological studies.
authors.affiliation: Center for Tobacco Control Research and Education, Cardiovascular Research Institute, and Division of Cardiology, University of California, San Francisco 94143-1390, USA.
authors.forename: Joaquin
authors.initials: J
authors.lastname: Barnoya
authors.forename: Stanton A
authors.initials: SA
authors.lastname: Glantz
mesh_terms: D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000209:etiology* / Q000473:pathology / Q000503:physiopathology; D004730:Endothelium, Vascular / Q000473:pathology; D006339:Heart Rate; D006801:Humans; D008928:Mitochondria / Q000473:pathology; D018384:Oxidative Stress; D015539:Platelet Activation; D012306:Risk; D012907:Smoking / Q000009:adverse effects; D014028:Tobacco Smoke Pollution / Q000009:adverse effects*; D014655:Vascular Resistance
chemical_list: D014028:Tobacco Smoke Pollution