Smoking as a risk factor for endothelial dysfunction.

Figure 1 summarizes some of the current knowledge about the effects of tobacco smoke on the vasculature. Tobacco smoke changes the balance of vascular biology towards thrombosis by effects on platelets and on coagulation factors. It changes the balance of vascular tone from vasodilation to vasoconstriction, through both depression of vasodilatory pathways and augmentation of vasoconstrictor pathways. Tobacco smoke also changes a large group of as yet incompletely characterized influences (promoting proliferation, atherogenesis and the instability of lesions) that are responsible for the clinical activity of tobacco smoke-induced vascular disease.