Smoking without exception adversely affects vascular structure and function in apparently healthy Chinese: implications in global atherosclerosis prevention.
BACKGROUND
Both active and passive smoking are prevalent in China but cardiovascular diseases were less prevalent in the past. We studied the current relationship between surrogate atherosclerosis markers and smoking in Chinese.


METHODS
Endothelium-dependent flow-mediated dilation (FMD) of brachial artery and carotid intima-media thickness (IMT) were measured non-invasively by ultrasound in 616 apparently healthy Chinese (23% smokers), recruited from greater China and the USA.


RESULTS
The Chinese smokers had significantly impaired FMD (7.0+/-2.3 vs. 8.2+/-2.5%, p<0.001) and endothelium-independent vasodilation (GTN, 17.4+/-3.9 vs. 18.7+/-4.1%, p=0.001) and thicker IMT (0.61+/-0.13 vs. 0.58+/-0.12 mm, p=0.025). 91% of the smokers were male. Both endothelium-dependent (6.9+/-2.2 vs. 8.0+/-2.5%, p<0.001) and independent (17.3+/-3.5 vs. 18.2+/-3.7%, p=0.047) vasodilation were significantly lower in the male smokers than non-smokers, although their age and cholesterol levels were lower. FMD-to-GTN ratio in the smokers were lower (0.41+/-0.12 vs. 0.45+/-0.13, p=0.005). Multivariate analyses confirmed an independent adverse impact of smoking on vascular functions. There were no consistent interactions between subject location and impact of smoking on FMD and IMT.


CONCLUSIONS
In these apparently healthy native and overseas Chinese subjects, smoking is adversely associated with endothelial dysfunction and arterial wall thickening, with serious implication in atherosclerosis prevention.
Thomas
G Neil
GN
The Chinese University of Hong Kong, Shatin, Hong Kong, China.
Chook
Ping
P
Yip
Thomas W C
TW
Kwong
Shu K
SK
Chan
Thomas Y K
TY
Qiao
Mu
M
Huang
Xin S
XS
Guo
Dong S
DS
Feng
Jian Z
JZ
Chan
Shu W
SW
Leong
Hok C
HC
Celermajer
David S
DS
Woo
Kam S
KS
D000293:Adolescent; D000328:Adult; D000368:Aged; D001213:Asian / Q000706:statistics & numerical data; D044466:Asian People / Q000706:statistics & numerical data; D050197:Atherosclerosis / Q000208:ethnology* / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control; D015415:Biomarkers; D002339:Carotid Arteries / Q000473:pathology*; D016022:Case-Control Studies; D002681:China / Q000453:epidemiology / Q000208:ethnology; D004730:Endothelium, Vascular / Q000503:physiopathology*; D005260:Female; D006723:Hong Kong / Q000453:epidemiology; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009131:Muscle, Smooth, Vascular / Q000503:physiopathology*; D012307:Risk Factors; D012495:San Francisco / Q000453:epidemiology; D012907:Smoking / Q000009:adverse effects*; D017539:Tunica Intima / Q000503:physiopathology
D015415:Biomarkers