Department of Internal Medicine, New York Presbyterian/Weill Cornell Medical Center, New York, NY, USA.
Cardiol Rev. 2013 Mar-Apr;21(2):94-100. doi: 10.1097/CRD.0b013e31827362e4.
In this review, we have sought to examine the epidemiological, basic science, and public health data regarding the association between second-hand smoke (SHS) exposure and the development of coronary heart disease (CHD). SHS increases the risk of CHD by 25-30% according to multiple cohort, case-control, and meta-analytical studies. Physiologic and basic science research suggest that the mechanisms by which SHS affects the cardiovascular system are multiple and include increased thrombogenesis and low-density lipoprotein oxidation, decreased exercise tolerance, dysfunctional flow-mediated vasodilatation, and activation of inflammatory pathways with concomitant oxidative damage and impaired vascular repair. As a result, chronic exposure promotes atherogenesis and the development of cardiovascular disease, increasing the risk of having an acute coronary syndrome (ACS). With the implementation of statewide and nationwide public smoke-free legislation across the United States and Europe, respectively, over the last 10-15 years, there has been a significant and reciprocal decline in the incidence of emergency admissions for ACS by an average 17% despite persistent attempts on the part of the tobacco industry to diminish the correlation between SHS exposure and CHD. These findings underscore the importance of the effects of smoking legislation on community health.
在这篇综述中，我们试图检查二手烟（SHS）暴露与冠心病（CHD）发展之间的流行病学、基础科学和公共卫生数据。多项队列研究、病例对照研究和荟萃分析表明，SHS 使 CHD 的风险增加 25-30%。生理和基础科学研究表明，SHS 影响心血管系统的机制是多方面的，包括增加血栓形成和低密度脂蛋白氧化、降低运动耐量、血流介导的血管扩张功能障碍、激活炎症途径以及伴随的氧化损伤和血管修复受损。因此，慢性暴露会促进动脉粥样硬化和心血管疾病的发展，增加急性冠状动脉综合征（ACS）的风险。在美国和欧洲，分别在过去 10-15 年实施了全州和全国范围的公共场所禁烟立法，尽管烟草业一直在努力削弱 SHS 暴露与 CHD 之间的相关性，但 ACS 的急诊入院率平均下降了 17%，这一趋势显著且呈反比关系。这些发现强调了吸烟立法对社区健康的重要性。
