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Achim A, Péter OÁ, Cocoi M, Serban A, Mot S, Dadarlat-Pop A, Nemes A, Ruzsa Z. Correlation between Coronary Artery Disease with Other Arterial Systems: Similar, Albeit Separate, Underlying Pathophysiologic Mechanisms. J Cardiovasc Dev Dis 2023; 10:jcdd10050210. [PMID: 37233177 DOI: 10.3390/jcdd10050210] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 05/09/2023] [Accepted: 05/10/2023] [Indexed: 05/27/2023] Open
Abstract
Atherosclerosis is a multifactorial systemic disease that affects the entire arterial tree, although some areas are more prone to lipid deposits than others. Moreover, the histopathological composition of the plaques differs, and the clinical manifestations are also different, depending on the location and structure of the atherosclerotic plaque. Some arterial systems are correlated with each other more than in that they simply share a common atherosclerotic risk. The aim of this perspective review is to discuss this heterogeneity of atherosclerotic impairment in different arterial districts and to investigate the current evidence that resulted from studies of the topographical interrelations of atherosclerosis.
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Affiliation(s)
- Alexandru Achim
- Department of Cardiology, "Niculae Stancioiu" Heart Institute, University of Medicine and Pharmacy "Iuliu Hatieganu", Motilor 19-21, 400001 Cluj-Napoca, Romania
- Department of Cardiology, Medizinische Universitätsklinik, Kantonsspital Baselland, Rheinstrasse 26, 4410 Liestal, Switzerland
- Department of Internal Medicine, Invasive Cardiology Division, University of Szeged, Semmelweis u. 8, 6725 Szeged, Hungary
| | | | - Mihai Cocoi
- Department of Cardiology, "Niculae Stancioiu" Heart Institute, University of Medicine and Pharmacy "Iuliu Hatieganu", Motilor 19-21, 400001 Cluj-Napoca, Romania
| | - Adela Serban
- Department of Cardiology, "Niculae Stancioiu" Heart Institute, University of Medicine and Pharmacy "Iuliu Hatieganu", Motilor 19-21, 400001 Cluj-Napoca, Romania
| | - Stefan Mot
- Department of Cardiology, "Niculae Stancioiu" Heart Institute, University of Medicine and Pharmacy "Iuliu Hatieganu", Motilor 19-21, 400001 Cluj-Napoca, Romania
| | - Alexandra Dadarlat-Pop
- Department of Cardiology, "Niculae Stancioiu" Heart Institute, University of Medicine and Pharmacy "Iuliu Hatieganu", Motilor 19-21, 400001 Cluj-Napoca, Romania
| | - Attila Nemes
- Department of Internal Medicine, Invasive Cardiology Division, University of Szeged, Semmelweis u. 8, 6725 Szeged, Hungary
| | - Zoltan Ruzsa
- Department of Internal Medicine, Invasive Cardiology Division, University of Szeged, Semmelweis u. 8, 6725 Szeged, Hungary
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Wang J, He L, Li W, Lv S. A Role of IL-17 in Rheumatoid Arthritis Patients Complicated With Atherosclerosis. Front Pharmacol 2022; 13:828933. [PMID: 35211020 PMCID: PMC8861488 DOI: 10.3389/fphar.2022.828933] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2021] [Accepted: 01/19/2022] [Indexed: 12/14/2022] Open
Abstract
Rheumatoid arthritis (RA) is mainly caused by joint inflammation. RA significantly increases the probability of cardiovascular disease. Although the progress of RA has been well controlled recently, the mortality of patients with RA complicated with cardiovascular disease is 1.5–3 times higher than that of patients with RA alone. The number of people with atherosclerosis in patients with RA is much higher than that in the general population, and atherosclerotic lesions develop more rapidly in patients with RA, which has become one of the primary factors resulting in the death of patients with RA. The rapid development of atherosclerosis in RA is induced by inflammation-related factors. Recent studies have reported that the expression of IL-17 is significantly upregulated in patients with RA and atherosclerosis. Simultaneously, there is evidence that IL-17 can regulate the proliferation, migration, and apoptosis of vascular endothelial cells and vascular smooth muscle cells through various ways and promote the secretion of several cytokines leading to the occurrence and development of atherosclerosis. Presently, there is no clear prevention or treatment plan for atherosclerosis in patients with RA. Therefore, this paper explores the mechanism of IL-17 in RA complicated with atherosclerosis and shows the reasons for the high incidence of atherosclerosis in patients with RA. It is hoped that the occurrence and development of atherosclerosis in patients with RA can be diagnosed or prevented in time in the early stage of lesions, and the prevention and treatment of cardiovascular complications in patients with RA can be enhanced to reduce mortality.
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Affiliation(s)
- Jiexin Wang
- Basic Medical College, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Linxi He
- Basic Medical College, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Weihong Li
- Basic Medical College, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Shangbin Lv
- Basic Medical College, Chengdu University of Traditional Chinese Medicine, Chengdu, China
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3
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Lin J, Xiang X, Qin Y, Gui J, Wan Q. Correlation of thyroid-related hormones with vascular complications in type 2 diabetes patients with euthyroid. Front Endocrinol (Lausanne) 2022; 13:1037969. [PMID: 36465631 PMCID: PMC9715611 DOI: 10.3389/fendo.2022.1037969] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 10/26/2022] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND This study aimed to evaluate the relationship between thyroid-related hormones and vascular complications in type 2 diabetes mellitus (T2DM) patients with euthyroidism. METHODS We enrolled 849 patients with T2DM after screening out the ineligible. Multivariate logistic regression was used to analyze the relationship between fT3, fT4, the fT3/fT4 ratio, thyroid-stimulating hormone, and diabetic vascular complications. Spearman correlation analysis was used to determine the correlation between thyroid-related hormones and vascular complications. RESULTS In this cross-sectional study of T2DM, 538 patients with carotid atherosclerosis (CA) and 299 patients with diabetic peripheral neuropathy (DPN). The prevalence of DPN was negatively correlated with fT3 and the fT3/fT4 ratio but positively correlated with fT4 (all P<0.01). At the same time, the odds ratio for DPN decreased with increasing fT3 (T1: reference; T2: OR: 0.689, 95%CI: 0.477, 0.993; T3: OR: 0.426, 95% CI: 0.286, 0.633, all P<0.05) and fT3/fT4 ratio (T1: reference; T2: OR: 0.528, 95% CI: 0.365, 0.763; T3: OR: 0.413, 95% CI: 0.278, 0.613, all P<0.001). In terms of sensitivity and specificity, fT4 was found to be 39.5% and 71.4% accurate, respectively, with a 95% CI of 0.531-0.611. CONCLUSIONS We found a negative correlation between fT3 and fT3/fT4 ratio and the number of individuals with DPN, and a positive correlation between fT4 and the prevalence of DPN.
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Affiliation(s)
- Jie Lin
- Department of Endocrinology and Metabolism, Affiliated Hospital of Southwest Medical University, Luzhou, China
- Metabolic Vascular Disease Key Laboratory of Sichuan Province, Luzhou, China
- Sichuan Clinical Research Center for Nephropathy, Luzhou, China
- Cardiovascular and Metabolic Diseases Key Laboratory of Luzhou, Luzhou, China
| | - Xin Xiang
- Department of Endocrinology and Metabolism, Affiliated Hospital of Southwest Medical University, Luzhou, China
- Metabolic Vascular Disease Key Laboratory of Sichuan Province, Luzhou, China
- Sichuan Clinical Research Center for Nephropathy, Luzhou, China
- Cardiovascular and Metabolic Diseases Key Laboratory of Luzhou, Luzhou, China
| | - Yahui Qin
- Department of Endocrinology and Metabolism, Affiliated Hospital of Southwest Medical University, Luzhou, China
- Metabolic Vascular Disease Key Laboratory of Sichuan Province, Luzhou, China
- Sichuan Clinical Research Center for Nephropathy, Luzhou, China
- Cardiovascular and Metabolic Diseases Key Laboratory of Luzhou, Luzhou, China
| | - Jing Gui
- Department of Endocrinology and Metabolism, Affiliated Hospital of Southwest Medical University, Luzhou, China
- Metabolic Vascular Disease Key Laboratory of Sichuan Province, Luzhou, China
- Sichuan Clinical Research Center for Nephropathy, Luzhou, China
- Cardiovascular and Metabolic Diseases Key Laboratory of Luzhou, Luzhou, China
| | - Qin Wan
- Department of Endocrinology and Metabolism, Affiliated Hospital of Southwest Medical University, Luzhou, China
- Metabolic Vascular Disease Key Laboratory of Sichuan Province, Luzhou, China
- Sichuan Clinical Research Center for Nephropathy, Luzhou, China
- Cardiovascular and Metabolic Diseases Key Laboratory of Luzhou, Luzhou, China
- *Correspondence: Qin Wan,
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Guo YL, Ampon RD, Hanigan IC, Knibbs LD, Geromboux C, Su TC, Negishi K, Poulos L, Morgan GG, Marks GB, Jalaludin B. Relationship between life-time exposure to ambient fine particulate matter and carotid artery intima-media thickness in Australian children aged 11-12 years. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2021; 291:118072. [PMID: 34592695 DOI: 10.1016/j.envpol.2021.118072] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Revised: 08/27/2021] [Accepted: 08/28/2021] [Indexed: 06/13/2023]
Abstract
Long-term exposure to air pollutants, especially particulates, in adulthood is related to cardiovascular diseases and vascular markers of atherosclerosis. However, whether vascular changes in children is related to exposure to air pollutants remains unknown. This study examined whether childhood exposure to air pollutants was related to a marker of cardiovascular risk, carotid intima-media thickness (CIMT) in children aged 11-12 years old. Longitudinal Study of Australian Children (LSAC) recruited parents and their children born in 2003-4. Among the participants, CheckPoint examination was conducted when the children were 11-12 years old. Ultrasound of the right carotid artery was performed using standardized protocols. Average and maximum far-wall CIMT, carotid artery distensibility, and elasticity were quantified using semiautomated software. Annual and life-time exposure to air pollutants was estimated using satellite-based land-use regression by residential postcodes. A total of 1063 children (50.4% girls) with CIMT data, serum cholesterol, and modeled estimates of NO2 and PM2.5 exposure for the period 2003 to 2015 were included. The average and maximum CIMT, carotid distensibility, and elasticity were 497 μm (standard deviation, SD 58), 580 μm (SD 44), 17.4% (SD 3.2), and 0.48%/mmHg (SD 0.09), respectively. The life-time average concentrations of PM2.5 and NO2 were 6.4 μg/m3 (SD 1.4) and 6.4 ppb (SD 2.4), respectively. Both average and maximum CIMT were significantly associated with average ambient PM2.5 concentration (average CIMT: +5.5 μm per μg/m3, 95% confidence interval, CI 2.4 to 8.5, and maximum CIMT: +4.9 μm per μg/m3, CI 2.3 to 7.6), estimated using linear regression, adjusting for potential confounders. CIMT was not significantly related to NO2 exposure. Carotid artery diameter, distensibility, and elasticity were not significantly associated with air pollutants. We conclude that life-time exposure to low levels of PM2.5 in children might have measurable adverse impacts on vascular structure by age 11-12 years.
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Affiliation(s)
- Yue Leon Guo
- Department of Environmental and Occupational Medicine, National Taiwan University (NTU) College of Medicine and NTU Hospital, Taipei, Taiwan; Institute of Environmental and Occupational Health Sciences, NTU College of Public Health, Taipei, Taiwan; National Institute of Environmental Health Sciences, National Health Research Institutes, Zhunan, Taiwan; Respiratory and Environmental Epidemiology, Woolcock Institute of Medical Research, University of Sydney, Australia.
| | - Rosario D Ampon
- Australian Centre for Airways Disease Monitoring, Woolcock Institute of Medical Research, University of Sydney, Australia
| | - Ivan C Hanigan
- University Centre for Rural Health, School of Public Health, The University of Sydney, Sydney, NSW, 2006, Australia; Health Research Institute, University of Canberra, Canberra, ACT, 2617, Australia; Centre for Air Pollution, Energy and Health Research (CAR), Sydney, NSW, 2006, Australia
| | - Luke D Knibbs
- Centre for Air Pollution, Energy and Health Research (CAR), Sydney, NSW, 2006, Australia; School of Public Health, University of Sydney, Sydney, NSW, 2006, Australia
| | - Christy Geromboux
- University Centre for Rural Health, School of Public Health, The University of Sydney, Sydney, NSW, 2006, Australia; Health Research Institute, University of Canberra, Canberra, ACT, 2617, Australia; Centre for Air Pollution, Energy and Health Research (CAR), Sydney, NSW, 2006, Australia
| | - Ta-Chen Su
- Department of Environmental and Occupational Medicine, National Taiwan University (NTU) College of Medicine and NTU Hospital, Taipei, Taiwan; Institute of Environmental and Occupational Health Sciences, NTU College of Public Health, Taipei, Taiwan; Department of Internal Medicine, National Taiwan University (NTU) College of Medicine and NTU Hospital, Taipei, Taiwan
| | - Kazuaki Negishi
- Sydney Medical School Nepean, Faculty of Medicine and Health, Charles Perkins Centre Nepean, The University of Sydney, NSW, Australia
| | - Leanne Poulos
- Australian Centre for Airways Disease Monitoring, Woolcock Institute of Medical Research, University of Sydney, Australia
| | - Geoffrey G Morgan
- University Centre for Rural Health, School of Public Health, The University of Sydney, Sydney, NSW, 2006, Australia; Centre for Air Pollution, Energy and Health Research (CAR), Sydney, NSW, 2006, Australia
| | - Guy B Marks
- Respiratory and Environmental Epidemiology, Woolcock Institute of Medical Research, University of Sydney, Australia; Centre for Air Pollution, Energy and Health Research (CAR), Sydney, NSW, 2006, Australia
| | - Bin Jalaludin
- Centre for Air Pollution, Energy and Health Research (CAR), Sydney, NSW, 2006, Australia; Ingham Institute for Applied Medical Research, University of New South Wales, Liverpool, NSW, Australia
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Yang IT, Hemphill LC, Kim JH, Bibangambah P, Sentongo R, Kakuhire B, Plutzky J, Boum Y, Tsai AC, Okello S, Siedner MJ. To fast or not to fast: Lipid measurement and cardiovascular disease risk estimation in rural sub-Saharan Africa. J Glob Health 2020; 10:010407. [PMID: 32257155 PMCID: PMC7101029 DOI: 10.7189/jogh.10.010407] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Background Cardiovascular disease (CVD) morbidity and mortality are increasing in sub-Saharan Africa (sSA), highlighting the need for tools to enable CVD risk stratification in the region. Although non-HDL-cholesterol (nHDL-C) has been promoted as a method to measure lipids without a requirement for fasting in the USA, its diagnostic validity has not been assessed in sSA. We sought to estimate: 1) the association between LDL-cholesterol (LDL-C) and nHDL-C, 2) the impact of fasting on their measurement, and 3) their correlation with carotid atherosclerosis, within a rural Ugandan population with high HIV prevalence. Methods We collected traditional CVD risk factors, blood for serum lipid levels, self-reported fasting status, and performed carotid ultrasonography in 301 participants in rural Uganda. We fit regression models, stratified by fasting status, to estimate associations between carotid intima media thickness (cIMT), LDL-C, and nHDL-C. Results Median age was 50 years (interquartile range = 46-54), 49% were female, 51% were HIV-positive, and at the time of blood collection, 70% had fasted overnight. Mean LDL-C, nHDL-C, and triglycerides in the non-fasting and fasting groups were 85 vs 88 mg/dL (P = 0.39), 114 vs 114 mg/dL (P = 0.98), and 130 vs 114 mg/dL (P = 0.05) mg/dL, respectively. In unadjusted models, mean cIMT (mm) was associated with both increased LDL-C (β = 0.0078 per 10mg/dL, P < 0.01) and nHDL-C (β = 0.0075, P < 0.01), and these relationships were similar irrespective of fasting status. After adjustment for traditional CVD risk factors, we observed similar associations, albeit with muted effect sizes within the fasting group. Conclusions We found a high correlation between LDL-C and nHDL-C, and both were correlated with cIMT, irrespective of fasting or HIV serostatus in rural Uganda. Our findings support use of either fasting or non-fasting serum lipids for CVD risk estimation in rural sSA.
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Affiliation(s)
- Isabelle T Yang
- Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, USA
| | - Linda C Hemphill
- Harvard Medical School, Boston, Massachusetts, USA.,Massachusetts General Hospital, Boston, Massachusetts, USA
| | - June-Ho Kim
- Harvard Medical School, Boston, Massachusetts, USA.,Brigham and Women's Hospital, Boston, Massachusetts, USA
| | | | - Ruth Sentongo
- Mbarara University of Science and Technology, Mbarara, Uganda
| | | | - Jorge Plutzky
- Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Yap Boum
- Mbarara University of Science and Technology, Mbarara, Uganda.,Epicentre Research Base, Mbarara, Uganda
| | - Alexander C Tsai
- Harvard Medical School, Boston, Massachusetts, USA.,Massachusetts General Hospital, Boston, Massachusetts, USA.,Mbarara University of Science and Technology, Mbarara, Uganda
| | - Samson Okello
- Mbarara University of Science and Technology, Mbarara, Uganda
| | - Mark J Siedner
- Harvard Medical School, Boston, Massachusetts, USA.,Massachusetts General Hospital, Boston, Massachusetts, USA.,Mbarara University of Science and Technology, Mbarara, Uganda
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Pistilli M, Howard VJ, Safford MM, Lee BK, Lovasi GS, Cushman M, Malek AM, McClure LA. Association of secondhand tobacco smoke exposure during childhood on adult cardiovascular disease risk among never-smokers. Ann Epidemiol 2019; 32:28-34.e1. [PMID: 30799203 PMCID: PMC6441374 DOI: 10.1016/j.annepidem.2019.01.012] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Revised: 12/11/2018] [Accepted: 01/25/2019] [Indexed: 11/24/2022]
Abstract
PURPOSE Adult secondhand tobacco smoke (SHS) exposure is related to stroke and coronary heart disease (CHD) risk, but long-term effects are less clear. We evaluated whether childhood SHS exposure affects subsequent stroke or CHD risk among adult black and white never-smokers followed for stroke and CHD. METHODS In this prospective cohort study, inverse probability weights were calculated to correct for bias due to attrition and survey nonresponse. Cox proportional hazards models were used to assess hazard ratios and 95% confidence intervals for stroke or CHD, separately, by number of childhood household smokers. RESULTS Of 13,142 eligible participants, 6136 had childhood SHS exposure assessed. Baseline mean (SD) age was 63.5 (9.0), 65% were female, 30% black, 46% reported 0 childhood household smokers, 36% reported 1, and 18% reported 2+. In 60,649 person-years, 174 strokes were observed (2.9% of participants), and in 45,195 person-years, 114 CHD events were observed (2.1% of participants). The weighted and adjusted hazard ratios (95% confidence intervals) of stroke for 2+ versus 0 childhood household smokers was 1.66 (1.29-2.13) and was 1.15 (0.82-1.59) for CHD. CONCLUSIONS We observed a significant association between childhood SHS exposure and stroke, but not CHD, after age 45 years and adjusting for missing information.
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Affiliation(s)
- Maxwell Pistilli
- Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA
| | - Virginia J Howard
- Department of Epidemiology, School of Public Health, University of Alabama, Birmingham
| | - Monika M Safford
- Department of Medicine, Weill Cornell Medical College, New York, NY
| | - Brian K Lee
- Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA
| | - Gina S Lovasi
- Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA
| | - Mary Cushman
- Department of Medicine, College of Medicine, University of Vermont, Burlington
| | - Angela M Malek
- Department of Public Health Sciences, Medical University of South Carolina, Charleston
| | - Leslie A McClure
- Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA.
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Gać P, Poręba M, Pawlas K, Sobieszczańska M, Poręba R. Influence of environmental tobacco smoke on morphology and functions of cardiovascular system assessed using diagnostic imaging. Inhal Toxicol 2019; 29:518-529. [PMID: 29458307 DOI: 10.1080/08958378.2017.1409847] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Exposure to tobacco smoke is a significant problem of environmental medicine. Tobacco smoke contains over one thousand identified chemicals including numerous toxicants. Cardiovascular system diseases are the major cause of general mortality. The recent development of diagnostic imaging provided methods which enable faster and more precise diagnosis of numerous diseases, also those of cardiovascular system. This paper reviews the most significant scientific research concerning relationship between environmental exposure to tobacco smoke and the morphology and function of cardiovascular system carried out using diagnostic imaging methods, i.e. ultrasonography, angiography, computed tomography and magnetic resonance imaging. In the forthcoming future, the studies using current diagnostic imaging methods should contribute to the reliable documentation, followed by the wide-spreading knowledge of the harmful impact of the environmental tobacco smoke exposure on the cardiovascular system.
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Affiliation(s)
- Paweł Gać
- a Department of Hygiene , Wroclaw Medical University , Wrocław , Poland.,b Department of Radiology and Diagnostic Imaging , 4th Military Hospital , Wroclaw , Poland
| | - Małgorzata Poręba
- c Department of Pathophysiology , Wroclaw Medical University , Wroclaw , Poland
| | - Krystyna Pawlas
- a Department of Hygiene , Wroclaw Medical University , Wrocław , Poland
| | | | - Rafał Poręba
- e Department of Internal Medicine, Occupational Diseases and Hypertension , Wroclaw Medical University , Wroclaw , Poland
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Starke RM, Thompson JW, Ali MS, Pascale CL, Martinez Lege A, Ding D, Chalouhi N, Hasan DM, Jabbour P, Owens GK, Toborek M, Hare JM, Dumont AS. Cigarette Smoke Initiates Oxidative Stress-Induced Cellular Phenotypic Modulation Leading to Cerebral Aneurysm Pathogenesis. Arterioscler Thromb Vasc Biol 2018; 38:610-621. [PMID: 29348119 DOI: 10.1161/atvbaha.117.310478] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2017] [Accepted: 01/04/2018] [Indexed: 12/22/2022]
Abstract
OBJECTIVE Cigarette smoke exposure (CSE) is a risk factor for cerebral aneurysm (CA) formation, but the molecular mechanisms are unclear. Although CSE is known to contribute to excess reactive oxygen species generation, the role of oxidative stress on vascular smooth muscle cell (VSMC) phenotypic modulation and pathogenesis of CAs is unknown. The goal of this study was to investigate whether CSE activates a NOX (NADPH oxidase)-dependent pathway leading to VSMC phenotypic modulation and CA formation and rupture. APPROACH AND RESULTS In cultured cerebral VSMCs, CSE increased expression of NOX1 and reactive oxygen species which preceded upregulation of proinflammatory/matrix remodeling genes (MCP-1, MMPs [matrix metalloproteinase], TNF-α, IL-1β, NF-κB, KLF4 [Kruppel-like factor 4]) and downregulation of contractile genes (SM-α-actin [smooth muscle α actin], SM-22α [smooth muscle 22α], SM-MHC [smooth muscle myosin heavy chain]) and myocardin. Inhibition of reactive oxygen species production and knockdown of NOX1 with siRNA or antisense decreased CSE-induced upregulation of NOX1 and inflammatory genes and downregulation of VSMC contractile genes and myocardin. p47phox-/- NOX knockout mice, or pretreatment with the NOX inhibitor, apocynin, significantly decreased CA formation and rupture compared with controls. NOX1 protein and mRNA expression were similar in p47phox-/- mice and those pretreated with apocynin but were elevated in unruptured and ruptured CAs. CSE increased CA formation and rupture, which was diminished with apocynin pretreatment. Similarly, NOX1 protein and mRNA and reactive oxygen species were elevated by CSE, and in unruptured and ruptured CAs. CONCLUSIONS CSE initiates oxidative stress-induced phenotypic modulation of VSMCs and CA formation and rupture. These molecular changes implicate oxidative stress in the pathogenesis of CAs and may provide a potential target for future therapeutic strategies.
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Affiliation(s)
- Robert M Starke
- From the Department of Neurological Surgery & Radiology, University of Miami Cerebrovascular Initiative (R.M.S., J.W.T.), Department of Biochemistry and Molecular Biology (M.T.), and Department of Cardiology and Molecular and Cellular Pharmacology (J.M.H.), University of Miami, FL; Department of Neurosurgery, University of Iowa, Iowa City (M.S.A., D.M.H.); Department of Neurological Surgery, Tulane University, New Orleans, LA (C.L.P., A.M.L., A.S.D.); Department of Neurosurgery (D.D.) and Department of Molecular Physiology & Biophysics, Robert M. Berne Cardiovascular Research Center (G.K.O.), University of Virginia, Charlottesville; and Department of Neurosurgery, Thomas Jefferson University, Philadelphia, PA (N.C., P.J.).
| | - John W Thompson
- From the Department of Neurological Surgery & Radiology, University of Miami Cerebrovascular Initiative (R.M.S., J.W.T.), Department of Biochemistry and Molecular Biology (M.T.), and Department of Cardiology and Molecular and Cellular Pharmacology (J.M.H.), University of Miami, FL; Department of Neurosurgery, University of Iowa, Iowa City (M.S.A., D.M.H.); Department of Neurological Surgery, Tulane University, New Orleans, LA (C.L.P., A.M.L., A.S.D.); Department of Neurosurgery (D.D.) and Department of Molecular Physiology & Biophysics, Robert M. Berne Cardiovascular Research Center (G.K.O.), University of Virginia, Charlottesville; and Department of Neurosurgery, Thomas Jefferson University, Philadelphia, PA (N.C., P.J.)
| | - Muhammad S Ali
- From the Department of Neurological Surgery & Radiology, University of Miami Cerebrovascular Initiative (R.M.S., J.W.T.), Department of Biochemistry and Molecular Biology (M.T.), and Department of Cardiology and Molecular and Cellular Pharmacology (J.M.H.), University of Miami, FL; Department of Neurosurgery, University of Iowa, Iowa City (M.S.A., D.M.H.); Department of Neurological Surgery, Tulane University, New Orleans, LA (C.L.P., A.M.L., A.S.D.); Department of Neurosurgery (D.D.) and Department of Molecular Physiology & Biophysics, Robert M. Berne Cardiovascular Research Center (G.K.O.), University of Virginia, Charlottesville; and Department of Neurosurgery, Thomas Jefferson University, Philadelphia, PA (N.C., P.J.)
| | - Crissey L Pascale
- From the Department of Neurological Surgery & Radiology, University of Miami Cerebrovascular Initiative (R.M.S., J.W.T.), Department of Biochemistry and Molecular Biology (M.T.), and Department of Cardiology and Molecular and Cellular Pharmacology (J.M.H.), University of Miami, FL; Department of Neurosurgery, University of Iowa, Iowa City (M.S.A., D.M.H.); Department of Neurological Surgery, Tulane University, New Orleans, LA (C.L.P., A.M.L., A.S.D.); Department of Neurosurgery (D.D.) and Department of Molecular Physiology & Biophysics, Robert M. Berne Cardiovascular Research Center (G.K.O.), University of Virginia, Charlottesville; and Department of Neurosurgery, Thomas Jefferson University, Philadelphia, PA (N.C., P.J.)
| | - Alejandra Martinez Lege
- From the Department of Neurological Surgery & Radiology, University of Miami Cerebrovascular Initiative (R.M.S., J.W.T.), Department of Biochemistry and Molecular Biology (M.T.), and Department of Cardiology and Molecular and Cellular Pharmacology (J.M.H.), University of Miami, FL; Department of Neurosurgery, University of Iowa, Iowa City (M.S.A., D.M.H.); Department of Neurological Surgery, Tulane University, New Orleans, LA (C.L.P., A.M.L., A.S.D.); Department of Neurosurgery (D.D.) and Department of Molecular Physiology & Biophysics, Robert M. Berne Cardiovascular Research Center (G.K.O.), University of Virginia, Charlottesville; and Department of Neurosurgery, Thomas Jefferson University, Philadelphia, PA (N.C., P.J.)
| | - Dale Ding
- From the Department of Neurological Surgery & Radiology, University of Miami Cerebrovascular Initiative (R.M.S., J.W.T.), Department of Biochemistry and Molecular Biology (M.T.), and Department of Cardiology and Molecular and Cellular Pharmacology (J.M.H.), University of Miami, FL; Department of Neurosurgery, University of Iowa, Iowa City (M.S.A., D.M.H.); Department of Neurological Surgery, Tulane University, New Orleans, LA (C.L.P., A.M.L., A.S.D.); Department of Neurosurgery (D.D.) and Department of Molecular Physiology & Biophysics, Robert M. Berne Cardiovascular Research Center (G.K.O.), University of Virginia, Charlottesville; and Department of Neurosurgery, Thomas Jefferson University, Philadelphia, PA (N.C., P.J.)
| | - Nohra Chalouhi
- From the Department of Neurological Surgery & Radiology, University of Miami Cerebrovascular Initiative (R.M.S., J.W.T.), Department of Biochemistry and Molecular Biology (M.T.), and Department of Cardiology and Molecular and Cellular Pharmacology (J.M.H.), University of Miami, FL; Department of Neurosurgery, University of Iowa, Iowa City (M.S.A., D.M.H.); Department of Neurological Surgery, Tulane University, New Orleans, LA (C.L.P., A.M.L., A.S.D.); Department of Neurosurgery (D.D.) and Department of Molecular Physiology & Biophysics, Robert M. Berne Cardiovascular Research Center (G.K.O.), University of Virginia, Charlottesville; and Department of Neurosurgery, Thomas Jefferson University, Philadelphia, PA (N.C., P.J.)
| | - David M Hasan
- From the Department of Neurological Surgery & Radiology, University of Miami Cerebrovascular Initiative (R.M.S., J.W.T.), Department of Biochemistry and Molecular Biology (M.T.), and Department of Cardiology and Molecular and Cellular Pharmacology (J.M.H.), University of Miami, FL; Department of Neurosurgery, University of Iowa, Iowa City (M.S.A., D.M.H.); Department of Neurological Surgery, Tulane University, New Orleans, LA (C.L.P., A.M.L., A.S.D.); Department of Neurosurgery (D.D.) and Department of Molecular Physiology & Biophysics, Robert M. Berne Cardiovascular Research Center (G.K.O.), University of Virginia, Charlottesville; and Department of Neurosurgery, Thomas Jefferson University, Philadelphia, PA (N.C., P.J.)
| | - Pascal Jabbour
- From the Department of Neurological Surgery & Radiology, University of Miami Cerebrovascular Initiative (R.M.S., J.W.T.), Department of Biochemistry and Molecular Biology (M.T.), and Department of Cardiology and Molecular and Cellular Pharmacology (J.M.H.), University of Miami, FL; Department of Neurosurgery, University of Iowa, Iowa City (M.S.A., D.M.H.); Department of Neurological Surgery, Tulane University, New Orleans, LA (C.L.P., A.M.L., A.S.D.); Department of Neurosurgery (D.D.) and Department of Molecular Physiology & Biophysics, Robert M. Berne Cardiovascular Research Center (G.K.O.), University of Virginia, Charlottesville; and Department of Neurosurgery, Thomas Jefferson University, Philadelphia, PA (N.C., P.J.)
| | - Gary K Owens
- From the Department of Neurological Surgery & Radiology, University of Miami Cerebrovascular Initiative (R.M.S., J.W.T.), Department of Biochemistry and Molecular Biology (M.T.), and Department of Cardiology and Molecular and Cellular Pharmacology (J.M.H.), University of Miami, FL; Department of Neurosurgery, University of Iowa, Iowa City (M.S.A., D.M.H.); Department of Neurological Surgery, Tulane University, New Orleans, LA (C.L.P., A.M.L., A.S.D.); Department of Neurosurgery (D.D.) and Department of Molecular Physiology & Biophysics, Robert M. Berne Cardiovascular Research Center (G.K.O.), University of Virginia, Charlottesville; and Department of Neurosurgery, Thomas Jefferson University, Philadelphia, PA (N.C., P.J.)
| | - Michal Toborek
- From the Department of Neurological Surgery & Radiology, University of Miami Cerebrovascular Initiative (R.M.S., J.W.T.), Department of Biochemistry and Molecular Biology (M.T.), and Department of Cardiology and Molecular and Cellular Pharmacology (J.M.H.), University of Miami, FL; Department of Neurosurgery, University of Iowa, Iowa City (M.S.A., D.M.H.); Department of Neurological Surgery, Tulane University, New Orleans, LA (C.L.P., A.M.L., A.S.D.); Department of Neurosurgery (D.D.) and Department of Molecular Physiology & Biophysics, Robert M. Berne Cardiovascular Research Center (G.K.O.), University of Virginia, Charlottesville; and Department of Neurosurgery, Thomas Jefferson University, Philadelphia, PA (N.C., P.J.)
| | - Joshua M Hare
- From the Department of Neurological Surgery & Radiology, University of Miami Cerebrovascular Initiative (R.M.S., J.W.T.), Department of Biochemistry and Molecular Biology (M.T.), and Department of Cardiology and Molecular and Cellular Pharmacology (J.M.H.), University of Miami, FL; Department of Neurosurgery, University of Iowa, Iowa City (M.S.A., D.M.H.); Department of Neurological Surgery, Tulane University, New Orleans, LA (C.L.P., A.M.L., A.S.D.); Department of Neurosurgery (D.D.) and Department of Molecular Physiology & Biophysics, Robert M. Berne Cardiovascular Research Center (G.K.O.), University of Virginia, Charlottesville; and Department of Neurosurgery, Thomas Jefferson University, Philadelphia, PA (N.C., P.J.)
| | - Aaron S Dumont
- From the Department of Neurological Surgery & Radiology, University of Miami Cerebrovascular Initiative (R.M.S., J.W.T.), Department of Biochemistry and Molecular Biology (M.T.), and Department of Cardiology and Molecular and Cellular Pharmacology (J.M.H.), University of Miami, FL; Department of Neurosurgery, University of Iowa, Iowa City (M.S.A., D.M.H.); Department of Neurological Surgery, Tulane University, New Orleans, LA (C.L.P., A.M.L., A.S.D.); Department of Neurosurgery (D.D.) and Department of Molecular Physiology & Biophysics, Robert M. Berne Cardiovascular Research Center (G.K.O.), University of Virginia, Charlottesville; and Department of Neurosurgery, Thomas Jefferson University, Philadelphia, PA (N.C., P.J.)
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9
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Lim Y, Kwon O, Kim JY. The Model for Evaluation on Blood Flow of Functional Food in Human Intervention Study. J Lipid Atheroscler 2018. [DOI: 10.12997/jla.2018.7.2.88] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Affiliation(s)
- Yeni Lim
- Department of Nutritional Science and Food Management, Ewha Womans University, Seoul, Korea
| | - Oran Kwon
- Department of Nutritional Science and Food Management, Ewha Womans University, Seoul, Korea
| | - Ji Yeon Kim
- Department of Food Science and Technology, Seoul National University of Science and Technology, Seoul, Korea
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10
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Jones MR, Magid HS, Al-Rifai M, McEvoy JW, Kaufman JD, Hinckley Stukovsky KD, Szklo M, Polak J, Burke GL, Post WS, Blaha MJ, Navas-Acien A. Secondhand Smoke Exposure and Subclinical Cardiovascular Disease: The Multi-Ethnic Study of Atherosclerosis. J Am Heart Assoc 2016; 5:e002965. [PMID: 27993830 PMCID: PMC5210438 DOI: 10.1161/jaha.115.002965] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2016] [Accepted: 10/14/2016] [Indexed: 01/19/2023]
Abstract
BACKGROUND Few studies have evaluated the association between secondhand smoke (SHS) and subclinical cardiovascular disease among ethnically diverse populations. This study assesses the impact of SHS on inflammation and atherosclerosis (carotid intima-media thickness, coronary artery calcification, and peripheral arterial disease). METHODS AND RESULTS We examined 5032 nonsmoking adults aged 45 to 84 years without prior cardiovascular disease participating in the Multi-Ethnic Study of Atherosclerosis (MESA) from 2000 to 2002. SHS exposure was determined by self-report, and urinary cotinine was measured in a representative subset (n=2893). The multi-adjusted geometric mean ratios (95% CIs) for high-sensitivity C-reactive protein and interleukin-6 comparing 407 participants with SHS ≥12 h/wk versus 3035 unexposed participants were 1.13 (1.02-1.26) and 1.04 (0.98-1.11), respectively. The multi-adjusted geometric mean ratio for carotid intima-media thickness was 1.02 (0.97-1.07). Fibrinogen and coronary artery calcification were not associated with SHS. The prevalence of peripheral arterial disease (ankle-brachial index ≤0.9 or ≥1.4) was associated with detectable urinary cotinine (odds ratio, 2.10; 95% CI, 1.09-4.04) but not with self-reported SHS. Urinary cotinine was not associated with inflammation or carotid intima-media thickness. CONCLUSIONS Despite limited exposure assessment, this study supports the association of SHS exposure with inflammation and peripheral arterial disease.
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Affiliation(s)
- Miranda R Jones
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Hoda S Magid
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Mahmoud Al-Rifai
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
- Ciccarone Center for the Prevention of Heart Disease, Johns Hopkins University, Baltimore, MD
| | - John W McEvoy
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
- Ciccarone Center for the Prevention of Heart Disease, Johns Hopkins University, Baltimore, MD
| | - Joel D Kaufman
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA
| | - Karen D Hinckley Stukovsky
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA
| | - Moyses Szklo
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Joseph Polak
- Department of Radiology, Tufts Medical Center, Tufts University School of Medicine, Boston, MA
| | - Gregory L Burke
- Division of Public Health Sciences, Wake Forest School of Medicine, Winston- Salem, NC
| | - Wendy S Post
- Division of Cardiology, Johns Hopkins University, Baltimore, MD
| | - Michael J Blaha
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
- Ciccarone Center for the Prevention of Heart Disease, Johns Hopkins University, Baltimore, MD
| | - Ana Navas-Acien
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
- Department of Environmental Health Sciences, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
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11
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Sung Y, Lee J, Tsai C, Lin C, Hsu Y, Lin J, Chu C, Peng G. Risk Factor Stratification for Intracranial Stenosis in Taiwanese Patients With Cervicocerebral Stenosis. J Am Heart Assoc 2015; 4:e002692. [PMID: 26672078 PMCID: PMC4845266 DOI: 10.1161/jaha.115.002692] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2015] [Accepted: 10/27/2015] [Indexed: 11/16/2022]
Abstract
BACKGROUND Intracranial stenosis (ICS) is a major determinant of ischemic stroke in Asians. We determined the clinical significance of different risk factors and the role of ICS in Taiwanese patients with varied distributions of cervicocerebral stenosis. METHODS AND RESULTS Presence of extracranial carotid stenosis (ECS, ≥70%) and ICS (>50%) was examined in 13 539 patients using ultrasonography and magnetic resonance angiography, respectively. Seven hundred thirty-three patients with non-ECS/ICS (n=372), isolated ICS (n=112), isolated ECS (n=121), or combined ECS/ICS (CEIS, n=128) were selected. Prevalence of ischemic stroke in each group was compared, and risk factors for stenosis were determined. The area under the receiver operating characteristic curve for each risk factor was calculated. Prevalence of ischemic stroke was highest in patients with CEIS (odds ratio 15.86; P<0.001), followed in decreasing order by those with isolated ICS (odds ratio 7.16; P<0.001), isolated ECS (odds ratio 1.77; P=0.011), and non-ECS/ICS. Multivariate logistic regression analysis revealed that hypertension, coronary artery disease, and smoking were risk factors for isolated ECS; hypertension, diabetes mellitus, coronary artery disease, and smoking were risk factors for isolated ICS; and diabetes mellitus, coronary artery disease, and smoking were risk factors for CEIS. Smoking, diabetes mellitus, and coronary artery disease were the greatest contributors to CEIS, isolated ICS, and isolated ECS, respectively. CONCLUSIONS CEIS was associated with higher odds of ischemic stroke compared with isolated ICS and isolated ECS. Smoking and diabetes mellitus, major determinants of CEIS and isolated ICS, should be targeted in therapeutic strategies to reduce the risk of ischemic stroke.
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Affiliation(s)
- Yueh‐Feng Sung
- Graduate Institute of Medical SciencesNational Defense Medical CenterTaipeiTaiwan
- Department of NeurologyTri‐Service General HospitalNational Defense Medical CenterTaipeiTaiwan
| | - Jiunn‐Tay Lee
- Department of NeurologyTri‐Service General HospitalNational Defense Medical CenterTaipeiTaiwan
| | - Chia‐Lin Tsai
- Graduate Institute of Medical SciencesNational Defense Medical CenterTaipeiTaiwan
- Department of NeurologyTri‐Service General HospitalNational Defense Medical CenterTaipeiTaiwan
| | - Chun‐Chieh Lin
- Department of NeurologyTri‐Service General HospitalNational Defense Medical CenterTaipeiTaiwan
| | - Yaw‐Don Hsu
- Department of NeurologyTri‐Service General HospitalNational Defense Medical CenterTaipeiTaiwan
| | - Jiann‐Chyun Lin
- Department of NeurologyTri‐Service General HospitalNational Defense Medical CenterTaipeiTaiwan
| | - Chi‐Ming Chu
- Department of EpidemiologySchool of Public HealthNational Defense Medical CenterTaipeiTaiwan
| | - Giia‐Sheun Peng
- Graduate Institute of Medical SciencesNational Defense Medical CenterTaipeiTaiwan
- Department of NeurologyTri‐Service General HospitalNational Defense Medical CenterTaipeiTaiwan
- Section of NeurologyDepartment of Internal MedicineTaipei Veterans General Hospital, Hsinchu BranchHsinchu CountyTaiwan
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12
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Malek AM, Cushman M, Lackland DT, Howard G, McClure LA. Secondhand Smoke Exposure and Stroke: The Reasons for Geographic and Racial Differences in Stroke (REGARDS) Study. Am J Prev Med 2015; 49:e89-97. [PMID: 26117341 PMCID: PMC4656115 DOI: 10.1016/j.amepre.2015.04.014] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2014] [Revised: 03/30/2015] [Accepted: 04/21/2015] [Indexed: 11/18/2022]
Abstract
INTRODUCTION Stroke is a major public health concern worldwide given the associated morbidity and mortality. Smoking is a risk factor for stroke, but the relationship between secondhand smoke (SHS) exposure and stroke has been inconsistent to date. The aim of the current study was to examine the association of SHS exposure and risk of stroke and its subtypes (ischemic and hemorrhagic stroke) among nonsmokers. METHODS Demographic and clinical characteristics were compared by SHS exposure status for African American and white nonsmokers aged ≥45 years in the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study in 2014. Hazard ratios (HRs) and corresponding 95% CIs were calculated by Cox proportional hazards models to assess the relationship between SHS exposure and stroke risk. RESULTS Of the 21,743 participants (38% African American, 45% male), SHS exposure in the past year was reported by 23%. Compared with those without SHS exposure, exposed participants were more likely to be female, white, younger, and reside with a smoker (all p<0.001). A total of 428 incident strokes were observed from April 2003 to March 2012 during a mean follow-up of 5.6 years. The risk of overall stroke was increased 30% among those with SHS exposure after adjustment for other stroke risk factors (95% CI=2%, 67%). This relationship appeared to be driven by ischemic strokes. CONCLUSIONS SHS exposure is independently associated with an increased risk of stroke. Future studies are needed to confirm these findings and examine the role of long-term effects of SHS exposure on stroke outcomes.
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Affiliation(s)
- Angela M Malek
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, South Carolina.
| | - Mary Cushman
- Departments of Medicine and Pathology, University of Vermont, Colchester, Vermont
| | - Daniel T Lackland
- Department of Neurosciences, Medical University of South Carolina, Charleston, South Carolina
| | - George Howard
- Department of Biostatistics, University of Alabama at Birmingham, Birmingham, Alabama
| | - Leslie A McClure
- Department of Biostatistics, University of Alabama at Birmingham, Birmingham, Alabama
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13
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West HW, Gall SL, Juonala M, Magnussen CG. Is Passive Smoking Exposure in Early Life a Risk Factor for Future Cardiovascular Disease? CURRENT CARDIOVASCULAR RISK REPORTS 2015. [DOI: 10.1007/s12170-015-0471-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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14
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Henriksson P, Lu Q, Diczfalusy U, Freyschuss A. Immediate effect of passive smoking on microcirculatory flow. Microcirculation 2015; 21:587-92. [PMID: 24698527 DOI: 10.1111/micc.12137] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2014] [Accepted: 03/31/2014] [Indexed: 01/02/2023]
Abstract
OBJECTIVE Exposure to SHS, as by passive smoking, seems to increase the incidence of cardiovascular events. It has been shown that active smoking of a single cigarette causes an immediate and significant decrease in microcirculatory blood flow velocity, whereas the acute effects of exposure to SHS on microcirculatory flow have as yet not been demonstrated. METHODS Healthy nonsmoking volunteers of both genders were studied during acute exposure to SHS of two cigarettes burning up to 10 minutes. Microvessels were examined by in vivo vital capillaroscopy (Capiflow(®)), allowing continuous assessment of CBV. RESULTS CBV decreased from 514 mm/sec (CI 383-646) at baseline to 306 mm/sec (CI 191-420) at end of SHS exposure with a further decrease to a nadir of 240 mm/sec (CI 155-325) four minutes after the end of this exposure (p < 0.0001; ANOVA). CONCLUSIONS The result of this study shows that passive inhalation of secondhand cigarette smoke induces an immediate and prolonged marked reduction in CBV in nonsmoking healthy volunteers.
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Affiliation(s)
- Peter Henriksson
- Department of Clinical Sciences, Danderyd Hospital, Karolinska Institutet, Stockholm, Sweden
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15
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Chen W, Yun M, Fernandez C, Li S, Sun D, Lai CC, Hua Y, Wang F, Zhang T, Srinivasan SR, Johnson CC, Berenson GS. Secondhand smoke exposure is associated with increased carotid artery intima-media thickness: the Bogalusa Heart Study. Atherosclerosis 2015; 240:374-9. [PMID: 25875389 DOI: 10.1016/j.atherosclerosis.2015.04.002] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2015] [Revised: 04/01/2015] [Accepted: 04/02/2015] [Indexed: 01/08/2023]
Abstract
BACKGROUND Secondhand smoke (SHS) exposure increases cardiovascular disease risk. The objective of this study was to examine the association of SHS exposure in childhood and adulthood with adult arterial thickness. METHODS The study cohort consisted of 415 nonsmoking adults (301 whites and 114 blacks; ages 26.2-48.0 years) enrolled in 2004-2010. The arterial wall thickness was measured as common, bulb and internal carotid artery intima-media thickness (IMT). SHS exposure data in childhood and adulthood were obtained by a questionnaire survey. RESULTS Increased adult composite carotid IMT was significantly associated with SHS exposure (regression coefficient, β = 53.1 μm, p < 0.001) after adjusting for race, age, gender, education, income, body mass index, systolic blood pressure, LDL cholesterol and triglycerides/HDL cholesterol ratio, with blacks (β = 81.2 μm, p = 0.005) and whites (β = 38.9 μm, p = 0.017) showing the same direction of the association. Furthermore, the SHS exposure in childhood showed a relatively stronger association with increased carotid IMT than the exposure in adulthood based on standardized βs (0.180 vs. 0.106); the same trend in the difference between childhood and adulthood exposure was noted for duration of SHS exposure (0.186 vs. 0.145). The covariates-adjusted composite carotid IMT showed a significant increasing trend by the order of exposure status of none, adulthood only, childhood only and both (p for trend<0.001). CONCLUSIONS If the relationship is causal, the associations observed in this study suggest that more awareness should be raised on the dangers of SHS exposure during childhood so that its effect may be mitigated and controlled early in the cardiovascular disease process.
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Affiliation(s)
- Wei Chen
- Department of Epidemiology, Tulane University, New Orleans, LA, USA.
| | - Miaoying Yun
- Department of Epidemiology, Tulane University, New Orleans, LA, USA; College of Life and Environment Sciences, Minzu University, Beijing, China
| | - Camilo Fernandez
- Department of Epidemiology, Tulane University, New Orleans, LA, USA
| | - Shengxu Li
- Department of Epidemiology, Tulane University, New Orleans, LA, USA
| | - Dianjianyi Sun
- Department of Epidemiology, Tulane University, New Orleans, LA, USA
| | - Chin-Chih Lai
- Department of Epidemiology, Tulane University, New Orleans, LA, USA; Department of Cardiology, Peking Union Medical College Hospital, Beijing, China
| | - Yingxiao Hua
- Department of Epidemiology, Tulane University, New Orleans, LA, USA
| | - Fu Wang
- Department of Epidemiology, Tulane University, New Orleans, LA, USA
| | - Tao Zhang
- Department of Epidemiology, Tulane University, New Orleans, LA, USA; Department of Biostatistics, School of Public Health, Shandong University, Jinan, China
| | | | - Carolyn C Johnson
- Department of Global Community Health and Behavioral Sciences, Tulane University, New Orleans, LA, USA
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Rosvall M, Persson M, Östling G, Nilsson P, Melander O, Hedblad B, Engström G. Risk factors for the progression of carotid intima-media thickness over a 16-year follow-up period: The Malmö Diet and Cancer Study. Atherosclerosis 2015; 239:615-21. [DOI: 10.1016/j.atherosclerosis.2015.01.030] [Citation(s) in RCA: 87] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2014] [Revised: 01/09/2015] [Accepted: 01/27/2015] [Indexed: 12/24/2022]
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Lefebvre G, Delaney JA, McClelland RL. Extending the Bayesian Adjustment for Confounding algorithm to binary treatment covariates to estimate the effect of smoking on carotid intima-media thickness: the Multi-Ethnic Study of Atherosclerosis. Stat Med 2014; 33:2797-813. [PMID: 24596278 PMCID: PMC4047170 DOI: 10.1002/sim.6123] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2013] [Revised: 01/27/2014] [Accepted: 02/06/2014] [Indexed: 11/08/2022]
Abstract
We illustrate the application of the Bayesian Adjustment for Confounding (BAC) algorithm when the treatment covariate is binary. Using data from the Multi-Ethnic Study of Atherosclerosis, we estimate the effect of ever smoking on common carotid artery intimal medial thickness among adult Caucasian participants (n=1378). Our novel implementation of the BAC algorithm is performed first from an outcome model perspective and second from a treatment model perspective with both inverse probability weighting and doubly-robust estimation techniques. The BAC results are compared with the results obtained using standard model averaging and full model strategies, giving a range of adjusted estimates between 45.50 and 65.30 μm for increased common carotid artery intimal medial thickness among ever smokers. For both perspectives, we observe that BAC offers similar performance to using the fully specified outcome and/or treatment model (the full outcome model ever smoking effect is 48.61 μm; 95% CI: (0.62, 96.60)). We then redo the analyses for the African American, Hispanic, and Chinese adult participants to study the robustness of these findings with reduced sample size. For the Chinese subcohort, which corresponds to the smallest sample size (n=436), we find that, from a treatment model perspective, BAC reduces the variability of the estimates in comparison with using a full model approach. This suggests that the use of BAC in conjunction with inverse probability weighting and doubly-robust estimation can be advantageous when applied to relatively small sample sizes. This conjecture is subsequently verified on the basis of three simulated experiments.
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18
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Starke RM, Ali MS, Jabbour PM, Tjoumakaris SI, Gonzalez F, Hasan DM, Rosenwasser RH, Owens GK, Koch WJ, Dumont AS. Cigarette smoke modulates vascular smooth muscle phenotype: implications for carotid and cerebrovascular disease. PLoS One 2013; 8:e71954. [PMID: 23967268 PMCID: PMC3743809 DOI: 10.1371/journal.pone.0071954] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2013] [Accepted: 07/05/2013] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND The role of smooth muscle cell (SMC) phenotypic modulation in the cerebral circulation and pathogenesis of stroke has not been determined. Cigarette smoke is a major risk factor for atherosclerosis, but potential mechanisms are unclear, and its role in SMC phenotypic modulation has not been established. METHODS AND RESULTS In cultured cerebral vascular SMCs, exposure to cigarette smoke extract (CSE) resulted in decreased promoter activity and mRNA expression of key SMC contractile genes (SM-α-actin, SM-22α, SM-MHC) and the transcription factor myocardin in a dose-dependent manner. CSE also induced pro-inflammatory/matrix remodeling genes (MCP-1, MMPs, TNF-α, IL-1β, NF-κB). CSE increased expression of KLF4, a known regulator of SMC differentiation, and siKLF4 inhibited CSE induced suppression of SMC contractile genes and myocardin and activation of inflammatory genes. These mechanisms were confirmed in vivo following exposure of rat carotid arteries to CSE. Chromatin immune-precipitation assays in vivo and in vitro demonstrated that CSE promotes epigenetic changes with binding of KLF4 to the promoter regions of myocardin and SMC marker genes and alterations in promoter acetylation and methylation. CONCLUSION CSE exposure results in phenotypic modulation of cerebral SMC through myocardin and KLF4 dependent mechanisms. These results provides a mechanism by which cigarette smoke induces a pro-inflammatory/matrix remodeling phenotype in SMC and an important pathway for cigarette smoke to contribute to atherosclerosis and stroke.
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MESH Headings
- Acetylation/drug effects
- Animals
- Carotid Arteries/cytology
- Carotid Arteries/drug effects
- Carotid Arteries/metabolism
- Carotid Arteries/pathology
- Cell Differentiation/drug effects
- Cerebrovascular Disorders/chemically induced
- Cerebrovascular Disorders/genetics
- Cerebrovascular Disorders/pathology
- DNA Methylation/drug effects
- Down-Regulation/drug effects
- Genetic Markers/genetics
- Histone Deacetylase 2/metabolism
- Histones/metabolism
- Kruppel-Like Factor 4
- Kruppel-Like Transcription Factors/antagonists & inhibitors
- Kruppel-Like Transcription Factors/metabolism
- Muscle, Smooth, Vascular/cytology
- Muscle, Smooth, Vascular/drug effects
- Muscle, Smooth, Vascular/metabolism
- Muscle, Smooth, Vascular/pathology
- Nuclear Proteins/genetics
- Phenotype
- Promoter Regions, Genetic/drug effects
- Promoter Regions, Genetic/genetics
- Rats
- Rats, Sprague-Dawley
- Smoke/adverse effects
- Tobacco Products/analysis
- Trans-Activators/genetics
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Affiliation(s)
- Robert M. Starke
- Joseph and Marie Field Cerebrovascular Research Laboratory, Division of Neurovascular and Endovascular Surgery, Department of Neurological Surgery, University of Virginia, Charlottesville, Virginia, United States of America
- Department of Neurological Surgery, University of Virginia, Charlottesville, Virginia, United States of America
| | - Muhammad S. Ali
- Joseph and Marie Field Cerebrovascular Research Laboratory, Division of Neurovascular and Endovascular Surgery, Department of Neurological Surgery, University of Virginia, Charlottesville, Virginia, United States of America
| | - Pascal M. Jabbour
- Joseph and Marie Field Cerebrovascular Research Laboratory, Division of Neurovascular and Endovascular Surgery, Department of Neurological Surgery, University of Virginia, Charlottesville, Virginia, United States of America
| | - Stavropoula I. Tjoumakaris
- Joseph and Marie Field Cerebrovascular Research Laboratory, Division of Neurovascular and Endovascular Surgery, Department of Neurological Surgery, University of Virginia, Charlottesville, Virginia, United States of America
| | - Fernando Gonzalez
- Joseph and Marie Field Cerebrovascular Research Laboratory, Division of Neurovascular and Endovascular Surgery, Department of Neurological Surgery, University of Virginia, Charlottesville, Virginia, United States of America
| | - David M. Hasan
- Department of Neurosurgery, University of Iowa, Iowa City, Iowa, United States of America
| | - Robert H. Rosenwasser
- Joseph and Marie Field Cerebrovascular Research Laboratory, Division of Neurovascular and Endovascular Surgery, Department of Neurological Surgery, University of Virginia, Charlottesville, Virginia, United States of America
| | - Gary K. Owens
- Department of Molecular Physiology and Biophysics, Robert M. Berne Cardiovascular Research Center, Charlottesville, Virginia, United States of America
| | - Walter J. Koch
- Center for Translational Medicine and Department of Pharmacology, Temple University, Philadelphia, Pennsylvania, United States of America
| | - Aaron S. Dumont
- Joseph and Marie Field Cerebrovascular Research Laboratory, Division of Neurovascular and Endovascular Surgery, Department of Neurological Surgery, University of Virginia, Charlottesville, Virginia, United States of America
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HIV and Cardiovascular Disease: The Impact of Cigarette Smoking. CURRENT CARDIOVASCULAR RISK REPORTS 2011. [DOI: 10.1007/s12170-011-0197-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Ultrasound Imaging of Carotid Intima-Media Thickness: an Office-Based Tool to Assist Physicians in Cardiovascular Risk Assessment. Curr Atheroscler Rep 2011; 13:431-6. [DOI: 10.1007/s11883-011-0200-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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21
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Battaglia C, Battaglia B, Mancini F, Persico N, Nappi RE, Paradisi R, Venturoli S. Cigarette Smoking Decreases the Genital Vascularization in Young Healthy, Eumenorrheic Women. J Sex Med 2011; 8:1717-25. [DOI: 10.1111/j.1743-6109.2011.02257.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
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22
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Furuta M, Tomofuji T, Ekuni D, Tamaki N, Yamamoto T, Azuma T, Irie K, Endo Y, Yamada S, Morita M. Relationship between periodontal condition and arterial properties in an adult population in Japan. Oral Dis 2010; 16:781-7. [DOI: 10.1111/j.1601-0825.2010.01688.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Abstract
Cigarette smoking is a well-established risk factor for all forms of stroke. While both the general public and the global healthcare system are aware of the vascular risks associated with smoking, the prevalence of tobacco use has remained largely unchanged over the last quarter of a century. Approximately one in five US adults are classified as regular smokers, with the initiation of smoking typically occurring during the teenage years. Although the increased risk of stroke associated with smoking is generally acknowledged, it is less well recognized that considerable scientific evidence implicates a strong dose-response relationship between smoking and stroke risk. In this article, we summarize the literature regarding smoking-related stroke risk, the dose-response relationship, and the costs of this detrimental habit to both the individual and society as a whole.
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Affiliation(s)
- Reena S Shah
- Department of Neurology, University of Maryland School of Medicine, 110 South Paca Street, Third Floor, Baltimore, MD 21201-1559, USA
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Ten-year time course of risk factors for increased carotid intima–media thickness: the Hoorn Study. ACTA ACUST UNITED AC 2010; 17:168-74. [DOI: 10.1097/hjr.0b013e3283319094] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Kallio K, Jokinen E, Saarinen M, Hämäläinen M, Volanen I, Kaitosaari T, Rönnemaa T, Viikari J, Raitakari OT, Simell O. Arterial intima-media thickness, endothelial function, and apolipoproteins in adolescents frequently exposed to tobacco smoke. Circ Cardiovasc Qual Outcomes 2010; 3:196-203. [PMID: 20197510 DOI: 10.1161/circoutcomes.109.857771] [Citation(s) in RCA: 76] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Exposure to tobacco smoke is associated with markers of preclinical atherosclerosis in adults, but its effect on arterial structure in adolescents is unknown. METHODS AND RESULTS Healthy 13-year-old adolescents from the atherosclerosis prevention trial STRIP were studied. Maximum carotid and aortic intima-media thickness and brachial artery flow-mediated dilation were measured in 494 adolescents using high-resolution ultrasound. Serum lipid, lipoprotein, and apolipoprotein (Apo) A-I and B concentrations were determined using standard methods. Exposure to tobacco smoke was measured annually between ages 8 and 13 years using serum cotinine concentrations, analyzed with gas chromatography. To define longitudinal exposure, cotinine values of children having serum cotinine measured 2 to 6 times during follow-up were averaged and divided into tertiles (exposure groups): low (n=160), intermediate (n=171), and high (n=163). Adolescents with higher longitudinal exposure to tobacco smoke had increased carotid intima-media thickness (exposure groups [mean+/-SD]: low, 0.502+/-0.079 mm; intermediate, 0.525+/-0.070 mm; high, 0.535+/-0.066 mm; P<0.001) and increased aortic intima-media thickness (exposure groups: low, 0.527+/-0.113 mm; intermediate, 0.563+/-0.139 mm; high, 0.567+/-0.126 mm; P=0.008). The flow-mediated dilation decreased when cotinine level increased (exposure groups: low, 10.43+/-4.34%; intermediate, 9.78+/-4.38%; high, 8.82+/-4.14%; P=0.004). Moreover, ApoB (P=0.014) and ApoB/ApoA-I ratio (P=0.045) increased with increase in cotinine level. The associations between tobacco smoke exposure and ultrasound variables were unchanged after adjusting for traditional atherosclerosis risk factors and for ApoB. CONCLUSIONS Frequent exposure to tobacco smoke is independently associated with arterial changes of preclinical atherosclerosis and increased ApoB levels among healthy adolescents. Clinical Trial Registration- clinicaltrials.gov. Identifier: NCT00223600.
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Affiliation(s)
- Katariina Kallio
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland.
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26
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Cho JG, Wheatley JR. The association of carotid artery disease with snoring and obstructive sleep apnoea: definitions, pathogenesis and treatment. Australas J Ultrasound Med 2010; 13:27-31. [PMID: 28191074 PMCID: PMC5024857 DOI: 10.1002/j.2205-0140.2010.tb00215.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Affiliation(s)
- Jin-Gun Cho
- Ludwig Engel Centre for Respiratory Research; Westmead Millennium Institute and University of Sydney; Westmead Hospital; Westmead New South Wales 2145 Australia
| | - John R Wheatley
- Ludwig Engel Centre for Respiratory Research; Westmead Millennium Institute and University of Sydney; Westmead Hospital; Westmead New South Wales 2145 Australia
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Liang LR, Wong ND, Shi P, Zhao LC, Wu LX, Xie GQ, Wu YF. Cross-sectional and longitudinal association of cigarette smoking with carotid atherosclerosis in Chinese adults. Prev Med 2009; 49:62-7. [PMID: 19465047 DOI: 10.1016/j.ypmed.2009.05.006] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2008] [Revised: 04/09/2009] [Accepted: 05/16/2009] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To assess the cross-sectional and longitudinal association of cigarette smoking with carotid atherosclerosis in middle-aged and older Chinese adults. METHODS The study population consisted of 1132 residents in Beijing (748 women and 384 men) aged 35 to 64 years. Information on baseline smoking characteristics, including smoking status and pack-years was collected in 1993-1994. The cohort was resurveyed in 2002 and common carotid artery intima-media thickness (CCA-IMT) and carotid plaques were measured by B-mode ultrasound. RESULTS The multivariable-adjusted mean CCA-IMT at resurvey was significantly associated with smoking status at both resurvey and baseline, and was 0.72 mm for consistent current smokers, 0.71 mm for former and inconsistent smokers, and 0.70 mm for consistent never smokers at both surveys, respectively (p-trend<0.01). The multivariable-adjusted odds ratio [OR, 95% confidence interval (CI)] of having carotid plaques was 1.5 (1.0-2.1) for consistent current smokers vs consistent never smokers. In addition, there was a significant dose-response relationship between baseline smoking pack-years and multivariable-adjusted mean CCA-IMT and risk of having carotid plaques at resurvey. CONCLUSION Smoking is associated with carotid atherosclerosis in middle-aged and older Chinese adults both cross-sectionally and longitudinally. Smoking cessation may play a significant role in prevention and control of cardiovascular diseases in China.
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Affiliation(s)
- Li-Rong Liang
- Department of Epidemiology, Cardiovascular Institute and Fu Wai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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Chiu YW, Chuang HY, Huang MC, Wu MT, Liu HW, Huang CT. Comparison of Plasma Antioxidant Levels and Related Metabolic Parameters Between Smokers and Non-smokers. Kaohsiung J Med Sci 2009; 25:423-30. [DOI: 10.1016/s1607-551x(09)70537-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
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Vascular responses to manual PC6 acupuncture in nonsmokers and smokers assessed by the second derivative of the finger photoplethysmogram waveform. J Acupunct Meridian Stud 2009; 1:58-62. [PMID: 20633457 DOI: 10.1016/s2005-2901(09)60009-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2007] [Accepted: 02/19/2008] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Smoking is reported to increase arterial stiffness. Indices obtained from the second derivative of digital volume pulse (SDDVP) waveform have been proposed to characterize vascular aging and arterial rigidity. PC6 (Neiguan) is a traditional acupoint in each forearm that has been shown to modify cardiovascular functioning. OBJECTIVE To investigate the acute effects of manual needling with PC6 on SDDVP indices in healthy chronic smoker and nonsmoker subjects. SUBJECTS AND METHODS Aging index (AI) was defined as (b - c - d - e)/a, B:A was calculated as the ratio of the absolute value for the height of the b wave (B) to that of the a wave (A), and D:A was calculated as the ratio of the absolute value for the height of the d wave (D) to that of the a wave (A). These indices derived of the wave components of SDDVP of healthy nonsmokers (n=40; 28.3+/-3.0 years old) vs. chronic smokers (n=30; 29.9+/-2.9 years old) were compared. The digital volume pulse (DVP) was obtained by measuring infrared light transmission through the finger. Of each subject, a DVP registration 20 minutes long was obtained. PC6 was stimulated unilaterally by manual needling for 5 minutes (1-6 minutes). SDDVP indices were compared in each subject in pre- vs. post-acupuncture periods (30 seconds vs. 18 minutes, respectively). RESULTS At baseline, we found significant difference in B:A between nonsmokers and smokers. Comparing pre- vs. post-acupuncture periods, B:A and D:A did not show significant differences among nonsmokers, but B:A improved significantly in smokers and AI improved significantly in both nonsmokers and smokers. CONCLUSION These findings suggest that manual needling with PC6 could revert some of the deleterious effects on vascular functioning produced by chronic cigarette smoking.
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30
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Honors and Awards * Bibliography of Peer-Reviewed Journal Articles. Am J Epidemiol 2008. [DOI: 10.1093/aje/kwn247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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31
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Pereira I, Laurindo I, Burlingame R, Anjos L, Viana V, Leon E, Vendramini M, Borba E. Auto-antibodies do not influence development of atherosclerotic plaques in rheumatoid arthritis. Joint Bone Spine 2008; 75:416-21. [DOI: 10.1016/j.jbspin.2008.01.022] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2007] [Accepted: 01/15/2008] [Indexed: 10/22/2022]
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Chelland Campbell S, Moffatt RJ, Stamford BA. Smoking and smoking cessation -- the relationship between cardiovascular disease and lipoprotein metabolism: a review. Atherosclerosis 2008; 201:225-35. [PMID: 18565528 DOI: 10.1016/j.atherosclerosis.2008.04.046] [Citation(s) in RCA: 220] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2007] [Revised: 04/22/2008] [Accepted: 04/30/2008] [Indexed: 12/17/2022]
Abstract
Cigarette smoking is generally accepted as the most preventable cause of death in the United States today. Individuals who smoke experience a wide range of physiologic side effects that increase the risk of cardiovascular disease (CVD), including insulin resistance, elevated catecholamine levels which contribute to an elevated heart rate and blood pressure, and hypercholesterolemia. The link between hypercholesterolemia and cardiovascular disease has been extensively researched and is undeniable. What is more, this link is strengthened in smokers as cigarette smoking is known to increase total cholesterol (TC), triglycerides (TG), and low-density lipoprotein (LDL), while acting to decrease the cardio-protective high-density lipoprotein (HDL). Alterations in the enzymes that control lipid transport may be a key underlying mechanism contributing to these health destroying effects. This review examines the current literature related to: (1) smoking, lipoproteins, and lipid-related enzymes; (2) the impact of nicotine, carbon monoxide and free radicals on physiologic parameters related to health; and (3) metabolic issues involving smoking cessation and nicotine replacement therapy.
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Affiliation(s)
- Sara Chelland Campbell
- Department of Nutrition, Food and Exercise Sciences, Florida State University, Tallahassee, FL 32306-1493, USA.
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Hannawi S, Haluska B, Marwick TH, Thomas R. Atherosclerotic disease is increased in recent-onset rheumatoid arthritis: a critical role for inflammation. Arthritis Res Ther 2008; 9:R116. [PMID: 17986352 PMCID: PMC2246234 DOI: 10.1186/ar2323] [Citation(s) in RCA: 119] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2007] [Revised: 10/16/2007] [Accepted: 11/06/2007] [Indexed: 11/10/2022] Open
Abstract
Rheumatoid arthritis (RA) patients have increased mortality and morbidity as a result of cardiovascular and cerebrovascular disease. What is not clear, however, is either how early accelerated atherosclerosis begins in RA or how soon risk factors must be rigorously controlled. Furthermore, given the strong relationship of vascular disease to RA mortality and of inflammation to the accelerated atherosclerosis associated with RA, it is important to evaluate indices that could serially and noninvasively quantify atherosclerotic disease in RA patients. The carotid intima-media thickness (cIMT) and plaque, measured by ultrasound, correlate closely with direct measurement of the local and systemic atherosclerotic burden. To investigate the presence of subclinical atherosclerosis in the early stages of RA, the cIMT and plaque were measured using carotid duplex scanning in 40 RA patients with disease duration < 12 months and in 40 control subjects matched for age, sex and established cardiovascular risk factors. Patients with RA had significantly higher average cIMT values and more plaque than the control group (cIMT 0.64 +/- 0.13 mm versus 0.58 +/- 0.09 mm, respectively; P = 0.03). In RA patients, the cIMT was predicted by age and C-reactive protein level at first presentation to the clinic (R2 = 0.64). C-reactive protein was associated with age of disease onset and history of smoking. Since inflammation has been shown to predate onset of clinical RA, the accelerated atherogenic process related to inflammation may precede RA symptom onset.
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Affiliation(s)
- Suad Hannawi
- Centre for Immunology and Cancer Research, University of Queensland, Princess Alexandra Hospital, Brisbane, QLD 4102, Australia.
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Cirillo P, Pacileo M, De Rosa S, Calabrò P, Gargiulo A, Angri V, Prevete N, Fiorentino I, Ucci G, Sasso L, Petrillo G, Musto D'Amore S, Chiariello M. HMG-CoA Reductase Inhibitors Reduce Nicotine-Induced Expression of Cellular Adhesion Molecules in Cultured Human Coronary Endothelial Cells. J Vasc Res 2007; 44:460-70. [PMID: 17657162 DOI: 10.1159/000106464] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2006] [Accepted: 05/16/2007] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Smoking predisposes to the development of atherosclerosis and of its complications. The mechanisms responsible for these effects are not completely understood. We have investigated whether nicotine might promote a proatherosclerotic state in human coronary endothelial cells (HCAECs), studying the role of 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitors in preventing these phenomena. METHODS AND RESULTS Real-time PCR showed that nicotine induced a dose-dependent increase in mRNA levels for vascular cellular adhesion molecule-1 (VCAM-1)/intercellular adhesion molecule-1 (ICAM-1). Fluorescent-activated cell sorting analysis showed that nicotine induced expression of functionally active VCAM-1/ICAM-1, since they increased leukocyte adherence to HCAECs. Oxygen free radicals, Rho A and nuclear factor kappaB (NF-kappaB) play a pivotal role in modulating these effects. Indeed, nicotine caused oxygen free radical production as well as activation of Rho A and NF-kappaB pathways, evaluated by malondialdehyde levels, pulldown assay and by electrophoretic mobility shift assay, respectively. Superoxide dimutase, Rho A (Y-27639) and NF-kappaB inhibitors (pyrrolidine dithiocarbamate ammonium, Bay 11-7082) suppressed nicotine effects on CAM expression. HMG-CoA reductase inhibitors prevented these nicotine-mediated effects by inhibiting free radical generation and by modulating activation of Rho A and NF-kappaB pathways. CONCLUSIONS Nicotine promotes CAM expression on HCAECs, shifting them toward a proatherosclerotic state. These effects might explain, at least in part, the deleterious cardiovascular consequences of cigarette smoking. HMG-CoA reductase inhibitors play an important role in preventing these phenomena.
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Affiliation(s)
- Plinio Cirillo
- Division of Cardiology, University of Naples Federico II, Naples, Italy.
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Hurst RT, Ng DWC, Kendall C, Khandheria B. Clinical Use of Carotid Intima-Media Thickness: Review of the Literature. J Am Soc Echocardiogr 2007; 20:907-14. [PMID: 17617324 DOI: 10.1016/j.echo.2007.02.028] [Citation(s) in RCA: 82] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2007] [Indexed: 01/01/2023]
Abstract
Carotid intima-media thickness (CIMT) is a simple and inexpensive tool to assess the cumulative effect of atherosclerotic risk factors and is an independent predictor of future cardiovascular risk. CIMT is commonly used as a surrogate end point in research trials as a marker of atherosclerosis. However, new software programs have made CIMT a clinically practical examination for risk evaluation. CIMT correlates with cardiac risk factors and is an independent predictor of future myocardial infarction and stroke risk. Tests for subclinical atherosclerosis, such as CIMT, will help clinicians to more effectively identify the vulnerable patient who would benefit from aggressive prevention intervention.
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B-Mode Ultrasound: A Noninvasive Method for Assessing Atherosclerosis. CARDIOVASCULAR MEDICINE 2007. [DOI: 10.1007/978-1-84628-715-2_86] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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Chang HS, Kim HC, Ahn SV, Hur NW, Suh I. Impact of Multiple Cardiovascular Risk Factors on the Carotid Intima-media Thickness in Young Adults: The Kangwha Study. J Prev Med Public Health 2007; 40:411-7. [PMID: 17917490 DOI: 10.3961/jpmph.2007.40.5.411] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Affiliation(s)
- Hoo Sun Chang
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Hyeon Chang Kim
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Song Vogue Ahn
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Nam Wook Hur
- Biomedical Research Group, Brain Korea 21 Hanyang, The Hospital for Rheumatic Disease, Hanyang University, Seoul, Korea
| | - Il Suh
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea
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Fan AZ, Paul-Labrador M, Merz CNB, Iribarren C, Dwyer JH. Smoking status and common carotid artery intima-medial thickness among middle-aged men and women based on ultrasound measurement: a cohort study. BMC Cardiovasc Disord 2006; 6:42. [PMID: 17067397 PMCID: PMC1634872 DOI: 10.1186/1471-2261-6-42] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2006] [Accepted: 10/26/2006] [Indexed: 11/10/2022] Open
Abstract
Background Cigarette smoking is an established causal factor for atherosclerosis. However, the smoking effect on different echogenic components of carotid arterial wall measured by ultrasound is not well elucidated. Methods Middle-aged men and women who had IMT measurement ≥ 0.7 mm at baseline and follow-up were included (N = 413, age 40–60 years at baseline in 1995). Intima-media thickness of common carotid artery (CCA-IMT) and its components (echogenic and echolucent layers) were measured at baseline and in the follow-up examination 3 years later. IMT and its components were compared across current, former and never smokers. Individual growth models were used to examine how smoking status was related to the baseline and progression of overall IMT and IMT components. Results For both men and women, current smoking was associated with thicker echogenic layer than never smokers; former smokers exhibited thinner echogenic layer than current smokers after adjustment for cigarette pack-years. Among women, current smoking was also associated with a thinned echolucent layer that resulted in a non-significant overall association of current smoking with IMT for women. Conclusion Cigarette smoking is associated with carotid artery morphological changes and the association is sex-dependent. The atherogenic effect of smoking appears to be partly reversible among former smokers. IMT measurement alone may not be adequate to detect carotid atherosclerosis associated with cigarette smoking among middle-age women.
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Affiliation(s)
- Amy Z Fan
- Prevention Research Center, Pacific Institute for Research and Evaluation, Berkeley, CA, USA
| | - Maura Paul-Labrador
- Department of Preventive Medicine, University of Southern California Keck School of Medicine, Los Angeles, CA, USA
| | - C Noel Bairey Merz
- Division of Cardiology, Department of Medicine, Cedars-Sinai Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
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Lee PN, Forey BA. Environmental Tobacco Smoke Exposure and Risk of Stroke in Nonsmokers: A Review With Meta-analysis. J Stroke Cerebrovasc Dis 2006; 15:190-201. [PMID: 17904075 DOI: 10.1016/j.jstrokecerebrovasdis.2006.05.002] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2006] [Revised: 05/04/2006] [Accepted: 05/18/2006] [Indexed: 11/29/2022] Open
Abstract
Our objective was to provide a comprehensive review of the epidemiologic evidence relating stroke to exposure to environmental tobacco smoke (passive smoking) in lifelong nonsmokers. In all, 7 prospective, 6 case-control, and 3 cross-sectional studies were identified that provided relevant information. The 16 studies varied considerably in design, exposure indices used, and disease definition. Based on 24 sex-specific relative risk estimates, and using current spousal exposure (or nearest equivalent) as the exposure index, meta-analysis gave an overall estimate of 1.25 (95% confidence interval 1.16-1.36), with no significant heterogeneity. There was no significant heterogeneity by sex, year of publication, fatality, or disease end point. There was some indication that relative risks were less elevated in prospective studies and in US or European studies. No elevation was seen for subarachnoid hemorrhage. The estimate was similar using ever rather than current exposure, or total rather than spousal exposure. Adjustment for risk factors other than age had no material effect on the estimate. Eight studies provided dose-response estimates, the combined relative risk for the highest level of exposure being 1.56 (95% confidence interval 1.34-1.82). Many studies have evident weaknesses, and recall bias and particularly publication bias are major concerns. Currently, the association is only suggestive of a possible causal relationship. A clearer picture could be obtained using data from existing very large prospective studies that have already provided risk estimates for passive smoking and heart disease, and by conducting large, well-designed studies of incident stroke.
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Affiliation(s)
- Peter N Lee
- P N Lee Statistics and Computing Ltd, Sutton, United Kingdom
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Crouse JR. Thematic review series: Patient-Oriented Research. Imaging atherosclerosis: state of the art. J Lipid Res 2006; 47:1677-99. [PMID: 16705212 DOI: 10.1194/jlr.r600012-jlr200] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The ability to image obstructive arterial disease brought about a revolution in clinical cardiovascular care; the development of newer technologies that image arterial wall thicknesses, areas, volumes, and composition allows valid imaging of atherosclerosis for the first time. Development of noninvasive imaging of atherosclerosis has further led to a quantum shift in research in the field by enabling the study of asymptomatic populations and thus allowing investigators to focus on preclinical disease without the many biases associated with the study of symptomatic patients. These noninvasive investigations have broad implications for clinical care as well. Coronary angiography, computed tomographic (CT) imaging of coronary calcium, intravascular ultrasound, multidetector CT angiography, B mode ultrasound of the carotid arteries, and MRI of the carotid arteries all have unique strengths and weaknesses for imaging atherosclerosis. Certain of these techniques are extremely useful as outcome variables for clinical trials, and others are uniquely useful as predictors of the risk of cardiovascular disease. All are informative in one way or another with regard to the role of plaque remodeling and composition in disease causation. CT and MRI technology are advancing very rapidly, and research and clinical uses of these imaging modalities promise to further advance our understanding of atherosclerosis and its prevention.
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Affiliation(s)
- John R Crouse
- Wake Forest University School of Medicine, Winston-Salem, NC 27157, USA.
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Flor N, Sardanelli F, Soldi S, Franceschelli G, Missiroli C, De Paoli F, Cornalba G. Unknown internal carotid artery atherosclerotic stenoses detected with biphasic multidetector computed tomography for head and neck cancer. Eur Radiol 2005; 16:866-71. [PMID: 16320057 DOI: 10.1007/s00330-005-0023-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2005] [Revised: 07/19/2005] [Accepted: 08/19/2005] [Indexed: 10/25/2022]
Abstract
The possibility of detecting unknown internal carotid artery stenoses in patients undergoing biphasic multidetector computed tomography (MDCT) for current or previous head and neck cancer was investigated in 52 patients who underwent four-row MDCT (4 mm x 1.25 mm collimation, pitch 3, kVp 120, mAs 140; 90-100 ml of non-ionic contrast agent at 2 ml/s, early and late phases). Vessel stenoses were classed as severe (70-99%), moderate (30-69%), or mild (<30%). Internal carotid arteries (ICAs) with vessel stenosis was found in 37 patients (age 67.0+/-9.8 years, median 69 years) and 67 ICAs. Four patients (age 65.5+/-9.7 years) had severe stenosis, all of them associated with contralateral moderate stenosis. Seventeen patients (age 70.35+/-9.78 years) had moderate stenosis, bilateral (n=7), associated with contralateral mild stenosis (n=8), unilateral (n=2). Sixteen patients (age 64.8+/-9.8 years) had mild stenosis, bilateral (n=10) or unilateral (n=6). Of the four patients with unknown MDCT-detected severe stenosis, three had a change of therapy: one endarterectomy before tumor surgery, one combined vascular and tumor surgery, and one patient with a previously treated hypopharyngeal cancer had carotid stenting. In conclusion, of 52 patients, four (7.7 %) had unknown severe ICA stenoses, three of them with relevant impact on therapy. ICAs should be carefully evaluated for atherosclerotic disease using biphasic MDCT for head and neck cancer.
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Affiliation(s)
- Nicola Flor
- Department of Diagnostic and Interventional Radiology, University of Milan, San Paolo Hospital, Italy.
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42
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Chen LH, Knutsen SF, Shavlik D, Beeson WL, Petersen F, Ghamsary M, Abbey D. The association between fatal coronary heart disease and ambient particulate air pollution: Are females at greater risk? ENVIRONMENTAL HEALTH PERSPECTIVES 2005; 113:1723-9. [PMID: 16330354 PMCID: PMC1314912 DOI: 10.1289/ehp.8190] [Citation(s) in RCA: 105] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
The purpose of this study was to assess the effect of long-term ambient particulate matter (PM) on risk of fatal coronary heart disease (CHD). A cohort of 3,239 nonsmoking, non-Hispanic white adults was followed for 22 years. Monthly concentrations of ambient air pollutants were obtained from monitoring stations [PM < 10 microm in aerodynamic diameter (PM10), ozone, sulfur dioxide, nitrogen dioxide] or airport visibility data [PM < 2.5 microm in aerodynamic diameter (PM2.5)] and interpolated to ZIP code centroids of work and residence locations. All participants had completed a detailed lifestyle questionnaire at baseline (1976), and follow-up information on environmental tobacco smoke and other personal sources of air pollution were available from four subsequent questionnaires from 1977 through 2000. Persons with prevalent CHD, stroke, or diabetes at baseline (1976) were excluded, and analyses were controlled for a number of potential confounders, including lifestyle. In females, the relative risk (RR) for fatal CHD with each 10-microg/m3 increase in PM2.5 was 1.42 [95% confidence interval (CI), 1.06-1.90] in the single-pollutant model and 2.00 (95% CI, 1.51-2.64) in the two-pollutant model with O3. Corresponding RRs for a 10-microg/m3 increase in PM(10-2.5) and PM10 were 1.62 and 1.45, respectively, in all females and 1.85 and 1.52 in postmenopausal females. No associations were found in males. A positive association with fatal CHD was found with all three PM fractions in females but not in males. The risk estimates were strengthened when adjusting for gaseous pollutants, especially O3, and were highest for PM2.5. These findings could have great implications for policy regulations.
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Affiliation(s)
- Lie Hong Chen
- Department of Epidemiology and Biostatistics, Loma Linda University, Loma Linda, California, USA
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43
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Scherer G. Biomonitoring of inhaled complex mixtures--ambient air, diesel exhaust and cigarette smoke. ACTA ACUST UNITED AC 2005; 57 Suppl 1:75-110. [PMID: 16092718 DOI: 10.1016/j.etp.2005.05.007] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Human biomonitoring comprises the determination of biomarkers in body-fluids, cells and tissues. Biomarkers are generally assigned to one of three classes, namely, biomarkers of exposure, effect or susceptibility. Since biomarkers represent steps in an exposure-disease continuum, their application in epidemiological studies ('molecular epidemiology') shows promise. However, to be a predictor of disease, a biomarker has to be validated. Validation criteria for a biomarker include intrinsic qualities such as specificity, sensitivity, knowledge of background in the population, existence of dose-response relationships, degree of inter- and intra-individual variability, knowledge of the kinetics, confounding and modifying factors. In addition, properties of the sampling and analytical procedures are of relevance, including constraints and non-invasiveness of sampling, stability of sample as well as simplicity, high sensitivity, specificity and speed of the analytical method. It is of particular importance to prove by suitable studies that the biomarker of exposure indicates the actual exposure, the biomarker of effect strongly predicts the actual risk of disease and the biomarker of susceptibility actually modifies the risk. Biomonitoring of the exposure to complex mixtures such as polluted ambient air, diesel exhaust or tobacco smoke is a particular challenge since these exposures have many constituents in common and many people were exposed to more than one of these mixtures. Data on the exposure to polycyclic aromatic hydrocarbons (PAH) and benzene from ambient air, diesel exhaust and tobacco smoke will be presented. In addition, some source-specific biomarkers such as nitro-arenes and nicotine metabolites as well as their application in population groups will be discussed. The second part of the presentation addresses the application of biomarkers for assessing so called 'potentially reduced exposure products' (PREPs). According to a recent report of the Institute of Medicine (USA), "reducing risk of disease by reducing exposure to tobacco toxicants is feasible" and "surrogate biological markers that are associated with tobacco-related diseases could be used to offer guidance as to whether or not PREPs are likely to be risk-reducing." In general, the same validation criteria apply as discussed above. In addition, it is suggested that a panel of biomarkers should be used, representing both smoke phases (gas and particulate phase) and the various chemical classes of smoke constituents (e.g., carbonyls, benzene, PAH, tobacco-specific nitrosamines, aromatic amines). Also, a panel of biomarkers of effect should cover the major known adverse effects of smoking (e.g., oxidative stress, inflammatory processes, lipid peroxidation, lipometabolic disorders, mutagenic effects). Biomarkers of nicotine and carbon monoxide uptake are of interest for evaluating the smoking and inhalation behavior, respectively. Finally, suitable study designs for evaluating PREPs are discussed. It is concluded that suitable biomarkers for assessing the exposure to complex mixtures such as ambient air, diesel exhaust and tobacco smoke as well as for evaluating the exposure-reducing properties of PREPs are already available. Future efforts should focus on the development and validation of biomarkers of effect.
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Affiliation(s)
- Gerhard Scherer
- ABF Analytisch-Biologisches Forschungslabor GmbH, Goethestr. 20, 80336 Muenchen, Germany.
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Jovelić S, Hajduković Z, Jovelić A, Raden S. [Cigarette smoking in military pilots and intima-media thickness of the carotid arteries]. VOJNOSANIT PREGL 2005; 62:365-70. [PMID: 15913040 DOI: 10.2298/vsp0505365j] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND It is well known that smoking is associated with an increase in arterial wall thickness. However, most studies of this problem have been undertaken in age and sex heterogenous groups, as well as in patients with already present other conventional risk factors. The aim of this study was to assess the effect of cigarette smoking on arterial wall thickness of the common carotid artery in asymptomatic pilots. METHODS The imaging of intima-media thickness of the posterior wall of the distal 1 cm of both common carotid arteries was performed using a B mode ultrasound device, in 39 pilots (37.05 +/- 6.66 years), for whom smoking was the single cardiovascular risk factor. Comparisons were made with 49 non-smokers (35.12 +/- 7.39 years). RESULTS The posterior walls of both common carotid arteries were thicker in smokers (left, p < 0.05; right, p > 0,05). Intima-media thickness was significantly lower on the right side than on the left side in both smokers and non-smokers (p < 0.01). CONCLUSION Cigarette smoking as the single cardiovascular risk factor was associated with the wall thickness of the carotid arteries in our study. This finding indicated that early atherosclerosis was already present in pilots-smokers entering middle age.
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Affiliation(s)
- Stojan Jovelić
- Vojnomedicinska akademija, Institut za vazduhoplovnu medicinu, Crnotravska 17, 11 040 Beograd, Srbija i Crna Gora.
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Künzli N, Jerrett M, Mack WJ, Beckerman B, LaBree L, Gilliland F, Thomas D, Peters J, Hodis HN. Ambient air pollution and atherosclerosis in Los Angeles. ENVIRONMENTAL HEALTH PERSPECTIVES 2005; 113:201-6. [PMID: 15687058 PMCID: PMC1277865 DOI: 10.1289/ehp.7523] [Citation(s) in RCA: 490] [Impact Index Per Article: 25.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/26/2004] [Accepted: 11/22/2004] [Indexed: 05/18/2023]
Abstract
Associations have been found between long-term exposure to ambient air pollution and cardiovascular morbidity and mortality. The contribution of air pollution to atherosclerosis that underlies many cardiovascular diseases has not been investigated. Animal data suggest that ambient particulate matter (PM) may contribute to atherogenesis. We used data on 798 participants from two clinical trials to investigate the association between atherosclerosis and long-term exposure to ambient PM up to 2.5 microm in aerodynamic diameter (PM2.5). Baseline data included assessment of the carotid intima-media thickness (CIMT), a measure of subclinical atherosclerosis. We geocoded subjects' residential areas to assign annual mean concentrations of ambient PM2.5. Exposure values were assigned from a PM2.5 surface derived from a geostatistical model. Individually assigned annual mean PM2.5 concentrations ranged from 5.2 to 26.9 microg/m3 (mean, 20.3). For a cross-sectional exposure contrast of 10 microg/m3 PM2.5, CIMT increased by 5.9% (95% confidence interval, 1-11%). Adjustment for age reduced the coefficients, but further adjustment for covariates indicated robust estimates in the range of 3.9-4.3% (p-values, 0.05-0.1). Among older subjects (greater than or equal to 60 years of age), women, never smokers, and those reporting lipid-lowering treatment at baseline, the associations of PM2.5 and CIMT were larger with the strongest associations in women 60 years of age (15.7%, 5.7-26.6%). These results represent the first epidemiologic evidence of an association between atherosclerosis and ambient air pollution. Given the leading role of cardiovascular disease as a cause of death and the large populations exposed to ambient PM2.5, these findings may be important and need further confirmation.
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Affiliation(s)
- Nino Künzli
- Division of Environmental Health, Department of Preventive Medicine, Atherosclerosis Research Unit, Keck School of Medicine, University of Southern California, Los Angeles, California 90033-9013, USA.
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46
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Abstract
Background Although smoking is known to be powerful risk factor for other vascular diseases, such as cardiac and peripheral vascular disease, only relatively recently has evidence for the role of smoking in the development of stroke been established. The reasons for this advance lie in the acknowledgement that stroke is a heterogeneous disease, in which its subtypes are associated with different risk factors. Furthermore, improvements in the stringency of epidemiological studies and the greater use of CT scanning have enabled the role of smoking in the development of stroke to be elucidated. Summary of review This is a qualitative examination of high quality epidemiological studies in which the role of smoking and passive smoking, as a risk factor for cerebral infarction, intracerebral haemorrhage and subarachnoid haemorrhage, is examined. In addition, the pathological mechanisms by which smoking or passive smoking may contribute to the development of stroke are reviewed. Conclusion Smoking is a crucial independent determinant of cerebral infarction and subarachnoid haemorrhage, however its role in intracerebral haemorrhage is unclear. Although studies are limited, there is evidence that exposure to passive smoking may also increase the risk of stroke. Smoking appears to be involved in the pathogenesis of stroke via direct injury to the vasculature and also by altering haemodynamic factors within the circulation. Importantly, smoking is modifiable risk factor for stroke. Therefore, the encouragement of smoking cessation may result in a substantial reduction in the incidence of this devastating disease.
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Affiliation(s)
- Seana L Paul
- National Stroke Research Institute, Austin Health, Heidelberg West, Victoria 3081, Australia
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Chiu HC, Mau LW, Chang HY, Lee TK, Liu HW, Chang YY. Risk Factors for Cardiovascular Disease in the Elderly in Taiwan. Kaohsiung J Med Sci 2004; 20:279-86. [PMID: 15253469 DOI: 10.1016/s1607-551x(09)70119-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
The major objective of the present study was to identify biologic and behavioral risk factors of cardiovascular disease (CVD) in the elderly population in Taiwan. It is hypothesized that the selected risk factors are significantly associated with the prevalence of CVD. Data came from a nationwide geriatric survey in 1991. Stratified proportional sampling was used to recruit 2,600 subjects. These were evaluated by family physicians working for the Departments of Family Medicine at four medical centers in four major cities in Taiwan. Univariate and multivariate logistic regression analyses were used to examine the associations between risk factors and the prevalence of CVD. The prevalence of CVD was 38.31%. Patients with CVD consistently had higher values for each selected risk factor except high-density lipoprotein-cholesterol (HDL-C) and glucose concentrations. The findings also indicated that hypertension, hypertriglyceridemia, low HDL-C concentration, ex-drinking status, and overweight were significantly associated with the prevalence of CVD among the elderly in Taiwan. The findings not only confirm the risk factors for CVD, but also invite more attention to be given to the importance of biologic and behavioral risk factors in CVD.
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Affiliation(s)
- Herng-Chia Chiu
- Graduate Institute of Public Health, Kaohsiung Medical University, Kaohsiung, Taiwan
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Ambrose JA, Barua RS. The pathophysiology of cigarette smoking and cardiovascular disease: an update. J Am Coll Cardiol 2004; 43:1731-7. [PMID: 15145091 DOI: 10.1016/j.jacc.2003.12.047] [Citation(s) in RCA: 1501] [Impact Index Per Article: 75.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2003] [Revised: 12/18/2003] [Accepted: 12/23/2003] [Indexed: 02/08/2023]
Abstract
Cigarette smoking (CS) continues to be a major health hazard, and it contributes significantly to cardiovascular morbidity and mortality. Cigarette smoking impacts all phases of atherosclerosis from endothelial dysfunction to acute clinical events, the latter being largely thrombotic. Both active and passive (environmental) cigarette smoke exposure predispose to cardiovascular events. Whether there is a distinct direct dose-dependent correlation between cigarette smoke exposure and risk is debatable, as some recent experimental clinical studies have shown a non-linear relation to cigarette smoke exposure. The exact toxic components of cigarette smoke and the mechanisms involved in CS-related cardiovascular dysfunction are largely unknown, but CS increases inflammation, thrombosis, and oxidation of low-density lipoprotein cholesterol. Recent experimental and clinical data support the hypothesis that cigarette smoke exposure increases oxidative stress as a potential mechanism for initiating cardiovascular dysfunction.
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Affiliation(s)
- John A Ambrose
- Comprehensive Cardiovascular Center, Saint Vincent Catholic Medical Centers of New York, New York, New York 10011, USA.
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Abstract
BACKGROUND Although active smoking acutely increases arterial stiffness, the association between arterial stiffness and chronic exposure to environmental tobacco smoke (ETS) has not been evaluated. We used baseline data from the Vitamin E Atherosclerosis Prevention Study to evaluate the association between ETS exposure and arterial stiffness among 227 healthy adult nonsmokers. METHODS B-mode ultrasonograms of the common carotid artery were used to compute the carotid arterial wall stiffness index beta. Beta was compared by the number of sources and daily hours of ETS exposure. RESULTS The carotid stiffness index beta was positively associated with age, body mass index (BMI), fasting glucose, and common carotid artery intima-media thickness (IMT). In the total sample, beta was not related to the number of ETS exposure sources. The carotid stiffness index beta increased with number of sources and daily hours of ETS in subjects with BMI > or =27.1 kg/m2 and IMT > or =0.707 mm. The association was not apparent in subjects with lower BMI or IMT (for number of ETS sources, interaction P values=0.006 and 0.01, respectively). For number of ETS sources, but not hours of exposure, positive associations were apparent among females (but not males) and among subjects > or =55 years old (but not younger subjects). CONCLUSIONS These data indicate that arterial stiffness is adversely associated with ETS in a dose-dependent manner among individuals with higher BMI and greater carotid artery IMT.
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Affiliation(s)
- Wendy J Mack
- Department of Preventive Medicine and Department of Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA.
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50
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Abstract
Cigarette smoking is a major cause of coronary heart disease, stroke, aortic aneurysm, and peripheral vascular disease. The risk is manifest both as an increased risk for thrombosis of narrowed vessels and as an increased degree of atherosclerosis in those vessels. The cardiovascular risks owing to cigarette smoking increase with the amount smoked and with the duration of smoking. Risks are not reduced by smoking cigarettes with lower machine-measured yields of tar and nicotine, but those who have only smoked pipes or cigars seem to have a lower risk for cardiovascular diseases. Cessation of cigarette smoking reduces disease risks, although risks may remain elevated for a decade or more after cessation.
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Affiliation(s)
- David M Burns
- University of California San Diego School of Medicine, San Diego, CA 92108, USA.
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