Arterial Stiffness Abates in Ex-Smokers by 10-Year Mark

BY LESLIE SABBAGH

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Former smokers who have quit for at least 10 years have arterial stiffness comparable with that of people who never smoked, according to a large cross-sectional Irish study.

Dr. Noor A. Jatoi of the department of pharmacology and therapeutics, Trinity College, Dublin, and coauthors compared arterial stiffness and smoking status in 554 hypertensive patients who had no cardiac or renal disease and who were not on vasoactive medications (DOI:10.1161/HYPERTENSIONAHA.107.087338).

Among the 554 patients, 150 currently smoked, 136 were former smokers, and 268 never smoked. The patients' mean age was 47.8 years. Former smokers were placed into one of three groups: those who had quit cigarettes for less than a year, those who had quit for 1-10 years, and those who had stopped for longer than 10 years.

At baseline, there was no significant difference among the groups in body mass index (BMI), and significantly more men than women had stopped smoking. The researchers evaluated aortic stiffness using pulse-wave velocity (PWV), transit time, and wave reflection measurements.

Compared with current and former smokers, patients who never smoked had significantly lower brachial and aortic systolic blood pressure. Smoking status and transit time, wave reflection, and PWV had a "direct linear relationship" that placed former smokers at levels between current smokers and nonsmokers, the researchers said.

The investigators found statistically significant direct relationships between the duration of smoking cessation and PWV, wave reflection, and transit time in ex-smokers, after adjusting for age, sex, BMI, and mean arterial pressure.

Current smokers and those patients who stopped smoking for less than 1 year had similar arterial stiffness. Subjects who had quit smoking between 1 and 10 years earlier had "intermediate levels" of stiffness, and those who had quit for more than 10 years had arterial stiffness not significantly different from that of those who had never smoked, the authors reported in the May issue of Hypertension.

This study is the first "to show that, in untreated hypertensive patients, a population characterized by already stiff vessels, chronic smoking further increases arterial stiffness," wrote the investigators.

"The high aortic stiffness and wave reflection seen with chronic smoking may be one of the underlying mechanisms for the increased cardiovascular events observed in hypertensive patients," the researchers said.

"Therefore, considering the independent prognostic usefulness of arterial stiffness in the hypertensive population, its assessment may not only identify hypertensive patients at higher cardiovascular risk, but may also be used to monitor arterial health in those who quit smoking," they concluded.

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