Second Department of Internal Medicine, Tokyo Medical University, Tokyo, Japan.
J Am Coll Cardiol. 2010 May 4;55(18):1979-87. doi: 10.1016/j.jacc.2009.12.042.
We prospectively and longitudinally determined the effects of smoking on the progression of arterial stiffening as well as the involvement of inflammation in this process.
Smoking is an important avoidable risk factor for cardiovascular disease, and arterial stiffness might be involved in the pathophysiology. No prospective study has examined the effect of continuous smoking on the age-associated progression of arterial stiffening.
In 2,054 Japanese subjects (40 +/- 8 years of age), brachial-ankle pulse wave velocity (baPWV) and serum C-reactive protein (CRP) levels were measured at the baseline and the end of a 5- to 6-year follow-up period.
The annual rate of change of the baPWV during the study period was significantly greater in the continuous heavy smokers (11.0 +/- 1.9 cm/s/year, n = 181) than in the never-smokers (5.5 +/- 0.6 cm/s/year, n = 1,018). This difference remained significant even after adjustments for covariates, including age (p < 0.05). In continuous smokers (n = 493), the mean number of cigarettes smoked/day during the study period showed a significant relationship with the changes in baPWV. No significant relationship was found between the change in baPWV and serum CRP levels.
Continuous smoking might accelerate the age-associated progression of structural stiffening of the large- to middle-size arteries. We also found a dose-response relationship between cigarette consumption and accelerated arterial stiffening. However, we failed to confirm any significant association between the rate of arterial stiffening and the serum CRP levels in the smokers.
我们前瞻性和纵向研究了吸烟对动脉僵硬度进展的影响,以及炎症在此过程中的作用。
吸烟是心血管疾病的一个重要可避免的危险因素,而动脉僵硬度可能与病理生理学有关。没有前瞻性研究检查过连续吸烟对与年龄相关的动脉僵硬度进展的影响。
在 2054 名日本受试者(40±8 岁)中,在基线和 5 至 6 年随访结束时测量了肱踝脉搏波速度(baPWV)和血清 C 反应蛋白(CRP)水平。
在研究期间,持续重度吸烟者(11.0±1.9cm/s/年,n=181)的 baPWV 年变化率明显大于从不吸烟者(5.5±0.6cm/s/年,n=1018)。即使在调整了包括年龄在内的混杂因素后,这种差异仍然具有统计学意义(p<0.05)。在持续吸烟者(n=493)中,研究期间每天吸烟的平均支数与 baPWV 的变化呈显著相关。baPWV 的变化与血清 CRP 水平之间没有显著关系。
持续吸烟可能加速大、中动脉结构僵硬的与年龄相关的进展。我们还发现吸烟量与动脉僵硬度加速之间存在剂量反应关系。然而,我们未能证实吸烟者的动脉僵硬度进展率与血清 CRP 水平之间存在任何显著关联。