Impact of smoking and smoking cessation on arterial stiffness and aortic wave reflection in hypertension. Hypertension. 2007:Mar 19;49:1-2.
Cigarette smoking is an important modifiable cardiovascular risk factor and pathophysiologic mechanisms may include a stiff vascular tree. Although smokers have stiffer arteries, whether smoking cessation is associated with reduced arterial stiffness is not known. The authors compared never-treated patients with essential hypertension (n = 554) 18 to 80 years of age (56% females) classified as current smokers (n = 150), ex-smokers (n = 136), and nonsmokers (n = 268). Ex-smokers were categorized into <1 year, >1 year, 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. Transit time was lower in current and ex-smokers compared with nonsmokers. 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.