Gallucci Giuseppina, Tartarone Alfredo, Lerose Rosa, Lalinga Anna Vittoria, Capobianco Alba Maria
Cardiology Unit, IRCCS-CROB Referral Cancer Center of Basilicata, Rionero in Vulture (PZ), Italy.
Department of Onco-Hematology, Division of Medical Oncology, IRCCS-CROB Referral Cancer Center of Basilicata, Rionero in Vulture (PZ), Italy.
J Thorac Dis. 2020 Jul;12(7):3866-3876. doi: 10.21037/jtd.2020.02.47.
Smoking increases mortality from all causes and has a crucial role in atherosclerotic cardiovascular disease (ASCVD). Active smoking and secondhand smoke exposure determine more than 30% of coronary heart disease (CHD) mortality. The exact mechanisms of cardiovascular damages are not well known, but the detrimental effect of smoking on endothelial function has long been recognized. Smoking elicits oxidative processes, negatively affects platelet function, fibrinolysis, inflammation and vasomotor function; all these proatherogenic effects double the 10-year risk of fatal events in smokers compared to non smokers. An intriguing issue about smoking is the vulnerability of female gender. The mortality from cardiovascular diseases (CVDs) is higher in female than male smokers and female smokers show a 25% higher risk of developing CHD than men with the same exposure to tobacco smoke. This female vulnerability seems to be related to genes involved in thrombin signaling. The effects of smoking cessation have also been extensively studied. Cessation at an early age (40 years) has an impressive 90% reduction in the excess risk of death. In this review we report recent data about the causal link between smoking and CVDs and about the benefits of smoking cessation.
吸烟会增加各种原因导致的死亡率，并且在动脉粥样硬化性心血管疾病（ASCVD）中起着关键作用。主动吸烟和接触二手烟导致超过30%的冠心病（CHD）死亡。心血管损害的确切机制尚不清楚，但吸烟对内皮功能的有害影响早已为人所知。吸烟引发氧化过程，对血小板功能、纤维蛋白溶解、炎症和血管舒缩功能产生负面影响；与不吸烟者相比，所有这些促动脉粥样硬化作用使吸烟者发生致命事件的10年风险增加一倍。关于吸烟的一个有趣问题是女性的易感性。女性吸烟者的心血管疾病（CVD）死亡率高于男性吸烟者，并且在接触相同烟草烟雾的情况下，女性吸烟者患冠心病的风险比男性高25%。这种女性易感性似乎与凝血酶信号传导相关的基因有关。戒烟的效果也得到了广泛研究。在早年（40岁）戒烟可使额外死亡风险显著降低90%。在本综述中，我们报告了关于吸烟与心血管疾病之间因果关系以及戒烟益处的最新数据。
