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(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

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