Department of Internal Medicine, University of Pisa, Via Roma, 6756100 Pisa, Italy.
Curr Pharm Des. 2010;16(23):2518-25. doi: 10.2174/138161210792062920.
Cigarette smoking is a powerful cardiovascular risk factor and smoking cessation is the single most effective lifestyle measure for the prevention of a large number of cardiovascular diseases. Impairment of endothelial function, arterial stiffness, inflammation, lipid modification as well as an alteration of antithrombotic and prothrombotic factors are smoking-related major determinants of initiation, and acceleration of the atherothrombotic process, leading to cardiovascular events. Cigarette smoking acutely exerts an hypertensive effect, mainly through the stimulation of the sympathetic nervous system. As concern the impact of chronic smoking on blood pressure, available data do not put clearly in evidence a direct causal relationship between these two cardiovascular risk factors, a concept supported by the evidence that no lower blood pressure values have been observed after chronic smoking cessation. Nevertheless, smoking, affecting arterial stiffness and wave reflection might have greater detrimental effect on central blood pressure, which is more closely related to target organ damage than brachial blood pressure. Hypertensive smokers are more likely to develop severe forms of hypertension, including malignant and renovascular hypertension, an effect likely due to an accelerated atherosclerosis.
吸烟是心血管疾病的一个重要危险因素，戒烟是预防多种心血管疾病的最有效生活方式措施。内皮功能障碍、动脉僵硬、炎症、脂质改变以及抗血栓和促血栓因素的改变是与吸烟相关的、导致动脉粥样硬化过程启动和加速的主要决定因素，从而导致心血管事件。吸烟会急性地产生高血压效应，主要是通过刺激交感神经系统。至于慢性吸烟对血压的影响，现有数据并未明确表明这两个心血管危险因素之间存在直接的因果关系，这一概念得到了以下证据的支持，即慢性戒烟后并未观察到血压值的降低。然而，吸烟会影响动脉僵硬和波反射，可能对中心血压产生更大的不利影响，中心血压与靶器官损伤的关系比肱动脉血压更为密切。高血压吸烟者更有可能发展为严重的高血压，包括恶性高血压和肾血管性高血压，这种效应可能是由于动脉粥样硬化加速所致。
