title: Smoking Behaviors and Arterial Stiffness Measured by Pulse Wave Velocity in Older Adults: The Atherosclerosis Risk in Communities (ARIC) Study.
abstract: Though smoking is strongly associated with peripheral vascular disease and arteriosclerosis, smoking's association with arterial stiffness has been inconsistent and mostly limited to a single arterial segment. We examined the relationship between smoking behaviors with arterial stiffness in multiple arterial segments among community dwelling older adults.
  
  
  
  The cross-sectional relationship between smoking behavior with carotid-femoral (cfPWV) and femoral-ankle pulse wave velocity (faPWV) was examined in 5,002 men and women, separately, of the Atherosclerosis Risk in Communities (ARIC) cohort study. Brachial-ankle PWV was also assessed and presented in Supplementary Material. Heckman selection models were used to control for selective attrition and death in the ARIC cohort.
  
  
  
  In women, faPWV was lower in current smokers compared to never smokers (-66.0cm/s; 95% confidence interval (95% CI): -94.6, -37.4), and was 1.0cm/s lower (95% CI: -1.8, -0.2) for every additional year a woman smoked, after adjustment for confounders. Among women, cfPWV was not associated with smoking status or cigarette pack-years. Additionally, no associations of smoking status and cigarette pack-years with PWV were observed among men. Years since smoking cessation was not associated with PWV in either gender.
  
  
  
  Both smoking status and cumulative smoking exposure were associated with lower peripheral arterial stiffness among women, but not among men. We did not observe an association between central arterial stiffness and smoking status in either gender. The profound and well-documented adverse effects of cigarette smoking on the vasculature may not include a sustained stiffening of the arteries measured at older age.
authors.affiliation: University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA; camplain@email.unc.edu.
authors.forename: Ricky
authors.initials: R
authors.lastname: Camplain
authors.affiliation: University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA;
authors.forename: Michelle L
authors.initials: ML
authors.lastname: Meyer
authors.affiliation: University of Texas at Austin, Austin, Texas, USA;
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Tanaka
authors.affiliation: University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA;
authors.forename: Priya
authors.initials: P
authors.lastname: Palta
authors.affiliation: Johns Hopkins University, Baltimore, Maryland, USA;
authors.forename: Sunil K
authors.initials: SK
authors.lastname: Agarwal
authors.affiliation: Baylor College of Medicine, Houston, Texas, USA;
authors.forename: David
authors.initials: D
authors.lastname: Aguilar
authors.affiliation: University of Mississippi Medical Center, Jackson, Mississippi, USA.
authors.forename: Kenneth R
authors.initials: KR
authors.lastname: Butler
authors.affiliation: University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA;
authors.forename: Gerardo
authors.initials: G
authors.lastname: Heiss
keywords: arterial stiffness; arteriosclerosis; blood pressure; central and peripheral arterial stiffness; health behavior; hypertension; smoking; smoking cessation; subclinical cardiovascular disease.