Cigarette Smoking and Progression of Atherosclerosis

Abstract

CIGARETTE SMOKING is widely accepted as a major risk factor for the development of clinical cardiovascular disease resulting from direct effects on atherosclerosis and hemostasis.¹ Cross-sectional studies have shown a relationship between active smoking and carotid artery atherosclerosis in population-based cohorts.^2,3 In addition, atherosclerosis has been associated with both current³ and past⁴ exposure to environmental tobacco smoke (ETS). Previous longitudinal studies in small populations have examined the association of smoking with the progression of atherosclerosis with mixed results. While an association was observed between duration of smoking and progression of carotid atherosclerosis among 100 Finnish men,⁵ no difference in the rate of atherosclerosis progression was shown between current smokers and those not currently smoking cigarettes in 3 other studies.^6-8 To our knowledge, no report has examined the impact of smoking, including ETS, in a large longitudinal cohort.