Impact of smoking and smoking cessation on arterial stiffness and aortic wave reflection in hypertension.
Cigarette smoking is an important modifiable cardiovascular risk factor and pathophysiological mechanisms may include a stiff vascular tree. Although smokers have stiffer arteries, whether smoking cessation is associated with reduced arterial stiffness is not known. We compared never-treated patients with essential hypertension (n=554) aged 18 to 80 years (56% females) classified as current smokers (n=150), ex-smokers (n=136), and nonsmokers (n=268). Ex-smokers were categorized into <1 year, >1 and <10 years, and >10 years of smoking cessation. Measurements included aortic stiffness, assessed as pulse wave velocity (Complior), wave reflection (augmentation index [AIx]), and transit time (T(R)) (Sphygmocor). Current and ex-smokers had significantly higher pulse wave velocity and AIx compared with nonsmokers (pulse wave velocity for current smokers: 10.7+/-0.2; ex-smokers: 10.6+/-0.2; nonsmokers: 9.9+/-0.1 m/s; P<0.001; AIx for current smokers: 31+/-1; ex-smokers: 30+/-1; nonsmokers: 27+/-0.8%; P<0.05), whereas T(R) was lower in current and ex-smokers compared with nonsmokers (T(R) for current smokers: 131+/-1.0; ex-smokers: 135+/-1; nonsmokers: 137+/-0.8 m/s; P<0.0001). There was a significant linear relationship between smoking status and pulse wave velocity (P<0.001), AIx (P<0.001), and T(R) (P<0.001), even after adjusting for age, sex, mean arterial pressure, heart rate, and body mass index. In ex-smokers, duration of smoking cessation had a significant linear relationship with improvement in pulse wave velocity (P<0.001), AIx (P<0.001), and T(R) (P<0.001), with arterial stiffness parameters returning to nonsignificant levels after a decade of smoking cessation.
Jatoi
Noor A
NA
Department of Pharmacology and Therapeutics, Trinity Centre for Health Sciences, St James's Hospital, Dublin 8, Ireland. jatoina@tcd.ie
Jerrard-Dunne
Paula
P
Feely
John
J
Mahmud
Azra
A
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001011:Aorta / Q000503:physiopathology*; D001158:Arteries / Q000503:physiopathology*; D001794:Blood Pressure; D004548:Elasticity; D005260:Female; D006801:Humans; D006973:Hypertension / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D011674:Pulse; D012907:Smoking; D016540:Smoking Cessation