Smoking, Smoking Cessation, and Measures of Subclinical Atherosclerosis in Multiple Vascular Beds in Japanese Men

Abstract

BackgroundSmoking is an overwhelming, but preventable, risk factor for cardiovascular diseases (CVD), although smoking prevalence remains high in developed and developing countries in East Asia.Methods and ResultsIn a population‐based sample of 1019 Japanese men aged 40 to 79 years, without CVD, we examined cross‐sectional associations of smoking status, cumulative pack‐years, daily consumption, and time since cessation, with subclinical atherosclerosis at 4 anatomically distinct vascular beds, including coronary artery calcification, carotid intima‐media thickness (CIMT) and plaque, aortic artery calcification (AoAC), and ankle‐brachial index. Current, former, and never smoking were present in 32.3%, 50.0%, and 17.7%, respectively. Compared to never smokers, current smokers had significantly higher risks of subclinical atherosclerosis in all 4 circulations (eg, odds ratios for coronary artery calcification >0, 1.79 [95% CIs, 1.16–2.79]; CIMT >1.0 mm, 1.88 [1.02–3.47]; AoAC >0, 4.29 [2.30–7.97]; and ankle‐brachial index <1.1, 1.78 [1.16–2.74]) and former smokers did in carotid and aortic circulations (CIMT >1.0 mm, 1.94 [1.13–3.34]; and AoAC >0, 2.55 [1.45–4.49]). Dose–response relationships of pack‐years and daily consumption, particularly with CIMT, carotid plaque, AoAC, and ankle‐brachial index, were observed among both current and former smokers, and even a small amount of pack‐years or daily consumption among current smokers was associated with coronary artery calcification and AoAC, whereas time since cessation among former smokers was linearly associated with lower burdens of all atherosclerotic indices.ConclusionsCigarette smoking was strongly associated with subclinical atherosclerosis in multiple vascular beds in Japanese men, and these associations attenuated with time since cessation.

Associations of Cigarette Smoking With Subclinical Inflammation and Atherosclerosis: ELSA‐Brasil (The Brazilian Longitudinal Study of Adult Health)

“…Limited studies have been conducted to assess associations of smoking or smoking cessation on markers of inflammation such as hsCRP,5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15 and even fewer studies have assessed measures of subclinical atherosclerosis 16, 17, 18, 19, 20, 21. These studies have generally shown higher levels of hsCRP among current and former smokers compared with nonsmokers5, 6, 9, 10, 12, 13, 14, 15 and decreased levels after smoking cessation, albeit slower than systolic blood pressure and total cholesterol and LDL‐C 8, 11, 12.…”

“…4 Deaths due to smoking-related cardiovascular disease (CVD) are generally preceded by subclinical cardiovascular injury that may be detected early in the disease process. Interest is rising in finding biomarkers of CVD-related injury in asymptomatic persons, [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21] and there is a need to identify sensitive biomarkers of smoking-related early subclinical cardiovascular damage. Such biomarkers may assist in risk identification and stratification among smokers.…”

Risk factors of carotid plaque and carotid common artery intima‐media thickening in a high‐stroke‐risk population

“…Also, there are already some studies about the risk factors of CPs or CIMT, for example, a study found that elevated resting heart rate is associated with an increased odds of CIMT and the presence of CPs (Wang, Zhang, Sun, Wang, & Cao, 2016). Another study revealed that when compared with nonsmoker, both former and current smokers have a greater risk of CIMT and CPs (Hisamatsu et al., 2016). There are also associations between dyslipidemia and CP; a cross‐sectional study revealed that TG is an independent predictor of CP risk (Mi et al., 2016), and another study showed that combined LDL‐C and HDL‐C levels can predict the presence of CPs, and the LDL‐C/HDL‐C ratio can act as an independent index for CIMT (Yang et al., 2014).…”

Coffee Consumption and Coronary Artery Calcium Score: Cross‐Sectional Results of ELSA‐Brasil (Brazilian Longitudinal Study of Adult Health)

“…Smoking behavior may wield a strong influence on an association between coffee consumption and CVD risk. Smokers are often more frequent coffee drinkers, and they are also inherently at greater risk of coronary artery disease and positively associated with subclinical atherosclerosis . Smoking may also intercede in the pathways through which coffee constituents are hypothesized to mediate effects on this disease.…”

“…Smokers are often more frequent coffee drinkers, 39 and they are also inherently at greater risk of coronary artery disease 39 and positively associated with subclinical atherosclerosis. 40,41 Smoking may also intercede in the pathways through which coffee constituents are hypothesized to mediate effects on this disease. If caffeine and coffee-derived antioxidants are important mediators of the association between coffee consumption and subclinical atherosclerosis, it is possible that deleterious effects of smoking overwhelm the influence of coffee intake on early CVD injury.…”