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Published Online
on March 19, 2007

Hypertension. 2007
Published online before print March 19, 2007, doi: 10.1161/HYPERTENSIONAHA.107.087338
A more recent version of this article appeared on May 1, 2007
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Submitted on January 11, 2007
Revised on January 28, 2007

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

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

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

* To whom correspondence should be addressed. E-mail: mahmuda{at}tcd.ie.

Abstract--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 (TR) (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 TR was lower in current and ex-smokers compared with nonsmokers (TR 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 TR (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 TR (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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