Martys R
I. Medizinischen Abteilung, Kaiserin-Elisabeth-Spitals der Stadt Wien.
Wien Med Wochenschr. 1994;144(22-23):556-60.
Cigarette smoking is a main risk-factor for enhanced cardiovascular morbidity and mortality. Some studies have even suggested that unvoluntary smoking increases the atherosclerotic risk. Smoking related cardiovascular diseases include coronary heart disease, acute myocardial infarction, sudden death, stroke, aortic aneurysm, atherosclerotic peripheral vascular disease. Risk is potentiated in patients with other coronary risk-factors i.e. hypertension and/or hypercholesterolemia. It is also proportionately related to the number of cigarettes smoked daily and smoking behavior. Combination of cigarette smoking and oral contraceptive use is the major cause of coronary events in female smokers under 50 years. Risk will be reduced only be smoking cessation. Underlying pathophysiologic mechanisms are complex; nicotine- and carbon-monoxide induced deleterious effects will be found on hemodynamic parameters, lipid status and hemorheology. Although clinical events due to acute coronary thrombosis and vasoconstriction are more often in smokers than in nonsmokers, angina pectoris is less common. Furthermore smoking diminishes beneficial effects of well established therapeutical procedures in treatment of coronary heart disease. Therefore, smoking cessation therapy should be a major goal for primary and secondary prevention programs as well.
吸烟是心血管疾病发病率和死亡率增加的主要危险因素。一些研究甚至表明，被动吸烟会增加动脉粥样硬化风险。与吸烟相关的心血管疾病包括冠心病、急性心肌梗死、猝死、中风、主动脉瘤、动脉粥样硬化性外周血管疾病。在患有其他冠心病危险因素（即高血压和/或高胆固醇血症）的患者中，风险会更高。它还与每日吸烟量和吸烟行为成比例相关。吸烟与口服避孕药并用是50岁以下女性吸烟者发生冠心病事件的主要原因。只有戒烟才能降低风险。潜在的病理生理机制很复杂；尼古丁和一氧化碳对血流动力学参数、血脂状况和血液流变学有有害影响。虽然吸烟者因急性冠状动脉血栓形成和血管收缩导致的临床事件比不吸烟者更常见，但心绞痛却较少见。此外，吸烟会削弱治疗冠心病的既定治疗方法的有益效果。因此，戒烟治疗也应成为一级和二级预防计划的主要目标。
