title: Associations Between Cardiovascular Risk Factors, Inflammation, and Progression of Carotid Atherosclerosis Among Smokers.
abstract: The high risk of cardiovascular events in smokers requires adequate control of other cardiovascular risk factors (CVRFs) to curtail atherosclerosis progression. However, it is unclear which CVRFs have the most influence on atherosclerosis progression in smokers.
  
  
  
  In 260 smokers aged 40-70 included in a smoking cessation trial, we analyzed the association between traditional CVRFs, high-sensitivity C-reactive protein (hs-CRP), smoking cessation and 3-year progression of carotid intima-media thickness (CIMT, assessed by repeated ultrasound measurements) in a longitudinal multivariate model.
  
  
  
  Participants (mean age 52 years, 47% women) had a mean smoking duration of 32 years with a median daily consumption of 20 cigarettes. Baseline CIMT was 1185 μm (95% confidence interval [CI]: 1082-1287) and increased by 93 μm (95% CI: 25-161) and 108 μm (95% CI: 33-183) after 1 and 3 years, respectively. Age, male sex, daily cigarette consumption, systolic blood pressure (SBP), but neither low-density lipoprotein cholesterol nor hs-CRP, were independently associated with baseline CIMT (all P ≤ .05). Baseline SBP, but neither low-density lipoprotein cholesterol nor hs-CRP, was associated with 3-year atherosclerosis progression (P = .01 at 3 years). The higher the SBP at baseline, the steeper was the CIMT increase over 3-year follow-up. We found an increase of 26 μm per each 10-mmHg raise in SBP at 1 year and an increase of 39 μm per each 10 mmHg raise in SBP at 3 years. Due to insufficient statistical power, we could not exclude an effect of smoking abstinence on CIMT progression.
  
  
  
  Control of blood pressure may be an important factor to limit atherosclerosis progression in smokers, besides support for smoking cessation.
  
  
  
  Among 260 smokers aged 40-70 years with a mean smoking duration of 32 years, baseline SBP was associated with atherosclerosis progression over 3 years, as measured by CIMT (P = .01 at 3 years), independently of smoking variables and other CVRFs. The higher the SBP at baseline, the steeper was the CIMT increase over 3-year follow-up. Our findings emphasize the importance of focusing not only on smoking cessation among smokers, but to simultaneously control other CVRFs, particularly blood pressure, in order to prevent future cardiovascular disease.
authors.affiliation: Department of Ambulatory Care and Community Medicine, Lausanne University Hospital, Lausanne, Switzerland;
authors.forename: Sarah
authors.initials: S
authors.lastname: Zingg
authors.affiliation: Department of Ambulatory Care and Community Medicine, Lausanne University Hospital, Lausanne, Switzerland; Service of Endocrinology, Diabetes and Metabolism, Lausanne University Hospital, Lausanne, Switzerland;
authors.forename: Tinh-Hai
authors.initials: TH
authors.lastname: Collet
authors.affiliation: Department of Ambulatory Care and Community Medicine, Lausanne University Hospital, Lausanne, Switzerland; Institute of Social and Preventive Medicine, Lausanne University Hospital, Lausanne, Switzerland;
authors.forename: Isabella
authors.initials: I
authors.lastname: Locatelli
authors.affiliation: Department of Ambulatory Care and Community Medicine, Lausanne University Hospital, Lausanne, Switzerland;
authors.forename: David
authors.initials: D
authors.lastname: Nanchen
authors.affiliation: Service of Angiology, Lausanne University Hospital, Lausanne, Switzerland;
authors.forename: Michèle
authors.initials: M
authors.lastname: Depairon
authors.affiliation: Institute of Social and Preventive Medicine, Lausanne University Hospital, Lausanne, Switzerland;
authors.forename: Pascal
authors.initials: P
authors.lastname: Bovet
authors.affiliation: Department of Ambulatory Care and Community Medicine, Lausanne University Hospital, Lausanne, Switzerland;
authors.forename: Jacques
authors.initials: J
authors.lastname: Cornuz
authors.affiliation: Department of General Internal Medicine, Inselspital, University of Bern, Bern, Switzerland nicolas.rodondi@insel.ch.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Rodondi
mesh_terms: D000328:Adult; D000368:Aged; D001794:Blood Pressure; D002097:C-Reactive Protein; D002340:Carotid Artery Diseases / Q000150:complications* / Q000453:epidemiology*; D005260:Female; D006801:Humans; D007249:Inflammation; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D000074285:Smokers / Q000706:statistics & numerical data*; D012907:Smoking / Q000453:epidemiology*
chemical_list: D002097:C-Reactive Protein