This Article Full Text Full Text (PDF) Correction (v50,pe11) All Versions of this Article: 49/5/981    most recent HYPERTENSIONAHA.107.087338v1 Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Jatoi, N. A. Articles by Mahmud, A. Search for Related Content PubMed PubMed Citation Articles by Jatoi, N. A. Articles by Mahmud, A. Pubmed/NCBI databases Medline Plus Health Information High Blood Pressure Quitting Smoking Smoking Related Collections Risk Factors Other hypertension Other arteriosclerosis Endothelium/vascular type/nitric oxide

(Hypertension. 2007;49:981.)
© 2007 American Heart Association, Inc.

Original Articles

Impact of Smoking and Smoking Cessation on Arterial Stiffness and Aortic Wave Reflection in Hypertension

Noor A. Jatoi; Paula Jerrard-Dunne; John Feely; Azra Mahmud

From the Department of Pharmacology and Therapeutics, Trinity College Dublin, Trinity Centre, St James’s Hospital, Dublin, Ireland.

Correspondence to Noor Ahmed Jatoi, Department of Pharmacology and Therapeutics, Trinity Centre for Health Sciences, St James’s Hospital, Dublin 8, Ireland. E-mail jatoina{at}tcd.ie

Cigarette smoking is an important modifiable cardiovascular risk factor and pathophysiological mechanisms may include a stiff vascular tree. Although smokers have stiffer arteries, whether smoking cessation is associated with reduced arterial stiffness is not known. We compared never-treated patients with essential hypertension (n=554) aged 18 to 80 years (56% females) classified as current smokers (n=150), ex-smokers (n=136), and nonsmokers (n=268). Ex-smokers were categorized into <1 year, >1 and <10 years, and >10 years of smoking cessation. Measurements included aortic stiffness, assessed as pulse wave velocity (Complior), wave reflection (augmentation index [AIx]), and transit time (T_R) (Sphygmocor). Current and ex-smokers had significantly higher pulse wave velocity and AIx compared with nonsmokers (pulse wave velocity for current smokers: 10.7±0.2; ex-smokers: 10.6±0.2; nonsmokers: 9.9±0.1 m/s; P<0.001; AIx for current smokers: 31±1; ex-smokers: 30±1; nonsmokers: 27±0.8%; P<0.05), whereas T_R was lower in current and ex-smokers compared with nonsmokers (T_R for current smokers: 131±1.0; ex-smokers: 135±1; nonsmokers: 137±0.8 m/s; P<0.0001). There was a significant linear relationship between smoking status and pulse wave velocity (P<0.001), AIx (P<0.001), and T_R (P<0.001), even after adjusting for age, sex, mean arterial pressure, heart rate, and body mass index. In ex-smokers, duration of smoking cessation had a significant linear relationship with improvement in pulse wave velocity (P<0.001), AIx (P<0.001), and T_R (P<0.001), with arterial stiffness parameters returning to nonsignificant levels after a decade of smoking cessation.

Key Words: smoking • arterial stiffness • pulse wave velocity • augmentation index • hypertension • smoking cessation

This article has been cited by other articles:

				M. Cecelja and P. Chowienczyk Dissociation of Aortic Pulse Wave Velocity With Risk Factors for Cardiovascular Disease Other Than Hypertension: A Systematic Review Hypertension, December 1, 2009; 54(6): 1328 - 1336. [Abstract] [Full Text] [PDF]

				J. D. Maclay, D. A. McAllister, N. L. Mills, F. P. Paterson, C. A. Ludlam, E. M. Drost, D. E. Newby, and W. MacNee Vascular Dysfunction in Chronic Obstructive Pulmonary Disease Am. J. Respir. Crit. Care Med., September 15, 2009; 180(6): 513 - 520. [Abstract] [Full Text] [PDF]

				K. Hnid Arterial Stiffness and Other Vasculatures Impairments That Cause in Hypertensive Older Patients and Smoking Cognitive Impairments Are Not Linked to Gender Stroke, September 1, 2009; 40(9): e539 - e539. [Full Text] [PDF]

				C. Vlachopoulos, P. Xaplanteris, N. Alexopoulos, K. Aznaouridis, C. Vasiliadou, K. Baou, E. Stefanadi, and C. Stefanadis Divergent Effects of Laughter and Mental Stress on Arterial Stiffness and Central Hemodynamics Psychosom Med, May 1, 2009; 71(4): 446 - 453. [Abstract] [Full Text] [PDF]

				K. Kallio, E. Jokinen, M. Hamalainen, M. Saarinen, I. Volanen, T. Kaitosaari, J. Viikari, T. Ronnemaa, O. Simell, and O. T. Raitakari Decreased Aortic Elasticity in Healthy 11-Year-Old Children Exposed to Tobacco Smoke Pediatrics, February 1, 2009; 123(2): e267 - e273. [Abstract] [Full Text] [PDF]

				K. I. Paraskevas, N. Bessias, T. T. Papas, C. D. Gekas, V. Andrikopoulos, and D. P. Mikhailidis Do Different Vascular Risk Factors Affect All Arteries Equally? Angiology, August 1, 2008; 59(4): 397 - 401. [Abstract] [PDF]

				N L Mills, J J Miller, A Anand, S D Robinson, G A Frazer, D Anderson, L Breen, I B Wilkinson, C M McEniery, K Donaldson, et al. Increased arterial stiffness in patients with chronic obstructive pulmonary disease: a mechanism for increased cardiovascular risk Thorax, April 1, 2008; 63(4): 306 - 311. [Abstract] [Full Text] [PDF]

				M. Shimizu and K. Kario Review: Role of the augmentation index in hypertension Therapeutic Advances in Cardiovascular Disease, February 1, 2008; 2(1): 25 - 35. [Abstract] [PDF]

				Z. Kabir Selection Bias, Confounding, or Information Bias? Hypertension, July 1, 2007; 50(1): e9 - e9. [Full Text] [PDF]