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Khan Minhas AM, Sedhom R, Jean ED, Shapiro MD, Panza JA, Alam M, Virani SS, Ballantyne CM, Abramov D. Global burden of cardiovascular disease attributable to smoking, 1990-2019: an analysis of the 2019 Global Burden of Disease Study. Eur J Prev Cardiol 2024; 31:1123-1131. [PMID: 38589018 DOI: 10.1093/eurjpc/zwae040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 01/16/2024] [Accepted: 01/28/2024] [Indexed: 04/10/2024]
Abstract
AIMS This study aims to investigate the trends in the global cardiovascular disease (CVD) burden attributable to smoking from 1990 to 2019. METHODS AND RESULTS Global Burden of Disease Study 2019 was used to analyse the burden of CVD attributable to smoking (i.e. ischaemic heart disease, peripheral artery disease, stroke, atrial fibrillation and flutter, and aortic aneurysm). Age-standardized mortality rates (ASMRs) per 100 000 and age-standardized disability-adjusted life year rates (ASDRs) per 100 000, as well as an estimated annual percentage change (EAPC) in ASMR and ASDR, were determined by age, sex, year, socio-demographic index (SDI), regions, and countries or territories. The global ASMR of smoking-attributed CVD decreased from 57.16/100 000 [95% uncertainty interval (UI) 54.46-59.97] in 1990 to 33.03/100 000 (95% UI 30.43-35.51) in 2019 [EAPC -0.42 (95% UI -0.47 to -0.38)]. Similarly, the ASDR of smoking-attributed CVD decreased between 1990 and 2019. All CVD subcategories showed a decline in death burden between 1990 and 2019. The burden of smoking-attributed CVD was higher in men than in women. Significant geographic and regional variations existed such that Eastern Europe had the highest ASMR and Andean Latin America had the lowest ASMR in 2019. In 2019, the ASMR of smoking-attributed CVD was lowest in high SDI regions. CONCLUSION Smoking-attributed CVD morbidity and mortality are declining globally, but significant variation persists, indicating a need for targeted interventions to reduce smoking-related CVD burden.
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Affiliation(s)
| | - Ramy Sedhom
- Division of Cardiology, Loma Linda University Medical Center, Loma Linda, 2068 Orange Tree Lane, Suite 215, Redlands, CA 92374, USA
| | - Estelle D Jean
- Department of Cardiology, Medstar Heart and Vascular Institute, Silver Springs, MD, USA
| | - Michael D Shapiro
- Section on Cardiovascular Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Julio A Panza
- Department of Cardiology, Westchester Medical Center, Valhalla, NY, USA
| | - Mahboob Alam
- Section of Cardiology, Baylor College of Medicine, Houston, TX, USA
| | - Salim S Virani
- Aga Khan University, Karachi, Pakistan
- Baylor College of Medicine and Texas Heart Institute, Houston, TX, USA
| | | | - Dmitry Abramov
- Division of Cardiology, Loma Linda University Medical Center, Loma Linda, 2068 Orange Tree Lane, Suite 215, Redlands, CA 92374, USA
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Saito M, Miyake Y, Tanaka K, Nagata C, Senba H, Hasebe Y, Miyata T, Higaki T, Kimura E, Matsuura B, Yamaguchi O, Kawamoto R. Smoking and secondhand smoke exposure and carotid intima-media thickness: Baseline data from the Aidai Cohort Study in Japan. Tob Induc Dis 2024; 22:TID-22-17. [PMID: 38250629 PMCID: PMC10798226 DOI: 10.18332/tid/175632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 11/17/2023] [Accepted: 11/21/2023] [Indexed: 01/23/2024] Open
Abstract
INTRODUCTION Epidemiological evidence regarding the relationship between smoking and secondhand smoke (SHS) exposure and carotid intima-media thickness (CIMT) has been limited in Asian populations. Employing baseline data from the Aidai Cohort Study, Japan, we evaluated the evidence in this cross-sectional study. METHODS Study subjects were 727 men aged 35-88 years and 1297 women aged 34-85 years. Information on smoking, SHS exposure, and confounders was obtained through a self-administered questionnaire. An automated carotid ultrasonography device was used to measure the right and left CIMT. The greatest CIMT measurement in the left or right common carotid artery was considered the maximum CIMT, and a maximum CIMT >1.0 mm was indicative of carotid wall thickening. Age, alcohol consumption, leisure time physical activity, hypertension, dyslipidemia, diabetes mellitus, body mass index, waist circumference, employment, and education level were adjusted at one time. RESULTS The prevalence of carotid wall thickening was 13.0%. The prevalence of never smoking was 30.5% in men and 90.1% in women. Among those who had never smoked, the prevalence of never SHS exposure at home and work was 74.3% and 48.2% in men and 38.3% and 56.3% in women, respectively. Active smoking and pack-years of smoking were independently positively related to carotid wall thickening regardless of sex, although the association with current smoking in women was not significant. Independent positive relationships were shown between former smoking and pack-years of smoking and maximum CIMT in men but not in women. No significant relationships were found between SHS exposure at home and work and carotid wall thickening or maximum CIMT in either men or women. CONCLUSIONS Active smoking, especially pack-years of smoking, was positively associated with carotid wall thickening in both sexes. Such positive associations with maximum CIMT were found only in men; however, interactions between smoking and sex were not significant.
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Affiliation(s)
- Makoto Saito
- Integrated Medical and Agricultural School of Public Health, Ehime University, Toon, Japan
- Department of Cardiology, Kitaishikai Hospital, Ozu, Japan
| | - Yoshihiro Miyake
- Integrated Medical and Agricultural School of Public Health, Ehime University, Toon, Japan
- Department of Epidemiology and Public Health, Ehime University Graduate School of Medicine, Toon, Japan
- Research Promotion Unit, Translation Research Center, Ehime University Hospital, Toon, Japan
- Center for Data Science, Ehime University, Matsuyama, Japan
| | - Keiko Tanaka
- Integrated Medical and Agricultural School of Public Health, Ehime University, Toon, Japan
- Department of Epidemiology and Public Health, Ehime University Graduate School of Medicine, Toon, Japan
- Research Promotion Unit, Translation Research Center, Ehime University Hospital, Toon, Japan
- Center for Data Science, Ehime University, Matsuyama, Japan
| | - Chisato Nagata
- Department of Epidemiology and Preventive Medicine, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Hidenori Senba
- Department of Epidemiology and Public Health, Ehime University Graduate School of Medicine, Toon, Japan
- Department of Internal Medicine, Matsuyama Shimin Hospital, Matsuyama, Japan
| | | | - Toyohisa Miyata
- Department of Epidemiology and Public Health, Ehime University Graduate School of Medicine, Toon, Japan
- Department of Regional Pediatrics and Perinatology, Ehime University Graduate School of Medicine, Toon, Japan
| | - Takashi Higaki
- Department of Regional Pediatrics and Perinatology, Ehime University Graduate School of Medicine, Toon, Japan
| | - Eizen Kimura
- Integrated Medical and Agricultural School of Public Health, Ehime University, Toon, Japan
- Center for Data Science, Ehime University, Matsuyama, Japan
- Department of Medical Informatics, Ehime University Graduate School of Medicine, Toon, Japan
| | - Bunzo Matsuura
- Department of Lifestyle-Related Medicine and Endocrinology, Ehime University Graduate School of Medicine, Toon, Japan
| | - Osamu Yamaguchi
- Integrated Medical and Agricultural School of Public Health, Ehime University, Toon, Japan
- Department of Cardiology, Pulmonology, Hypertension and Nephrology, Ehime University Graduate School of Medicine, Toon, Japan
| | - Ryuichi Kawamoto
- Integrated Medical and Agricultural School of Public Health, Ehime University, Toon, Japan
- Department of Community Medicine, Ehime University Graduate School of Medicine, Toon, Japan
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Potgurski DS, Ribeiro GE, da Silva DPC. Occurrence of changes in the auditory evoked potentials of smokers: systematic review of the literature. Codas 2023; 35:e20210273. [PMID: 37556701 PMCID: PMC10446745 DOI: 10.1590/2317-1782/20232021273pt] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 07/20/2022] [Indexed: 08/11/2023] Open
Abstract
PURPOSE To verify the occurrence of abnormal auditory evoked potentials (AEP) tests in adult smokers. RESEARCH STRATEGIES Systematic review of the literature according to the PRISMA guidelines, to answer the question: "Are there any changes in the AEP results in adult smokers?", PECOS strategy. Research carried out on PubMed, Embase, CINAHL, LIVIVO, Scopus, Web of Science, LILACS and Scielo databases. Additional search of gray literature: Google Scholar and ProQuest hand searching of reference lists of the included studies. SELECTION CRITERIA Cross-sectional studies were selected, without restriction on the year of publication and language. DATA ANALYSIS First, the titles and abstracts of all the studies were analyzed, followed by the full reading of the eligible studies. RESULTS 898 articles were collected, after the duplicate studies were removed and after blind analysis by three researchers, 8 studies of the observational type were selected. Most studies have found an association between active smoking and changes in electrophysiological tests. CONCLUSION Normal hearing adult smokers present alterations in short and long AEP. In the auditory brainstem response, the main altered components were the increase in waves latencies of I and III and in the interpeaks I - III and III - V, as well as a decrease in the amplitude of the waves. In Mismatch Negativity, there was a significant increase in wave amplitude and latency. In the long latency potential, P300, there was an increase in latencies and decreased amplitudes in the components N1 (in Fz) and P3.
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Affiliation(s)
- Dayane Stephanie Potgurski
- Departamento de Fonoaudiologia, Universidade Federal de Santa Catarina - UFSC - Florianópolis (SC), Brasil.
| | - Georgea Espindola Ribeiro
- Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo - HCFMUSP - São Paulo (SP), Brasil.
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Hahad O, Schmitt VH, Arnold N, Keller K, Prochaska JH, Wild PS, Schulz A, Lackner KJ, Pfeiffer N, Schmidtmann I, Michal M, Schattenberg JM, Tüscher O, Daiber A, Münzel T. Chronic cigarette smoking is associated with increased arterial stiffness in men and women: evidence from a large population-based cohort. Clin Res Cardiol 2023; 112:270-284. [PMID: 36068365 PMCID: PMC9898409 DOI: 10.1007/s00392-022-02092-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 08/24/2022] [Indexed: 02/06/2023]
Abstract
BACKGROUND Cigarette smoking is a threat to global human health and a leading cause of the cardiovascular disease (CVD) morbidity and mortality. Importantly, sex-specific differences in smoking-induced arterial stiffness, an early key event in the development of atherosclerotic CVD, remain still elusive. Thus, this study sought out to investigate sex-specific associations between smoking and measures of arterial stiffness. METHODS AND RESULTS Overall, 15,010 participants (7584 men and 7426 women aged 35-74 years) of the Gutenberg Health Study were examined at baseline during 2007-2012. Smoking status, pack-years of smoking, and years since quitting smoking were assessed by a standardized computer-assisted interview. Arterial stiffness and wave reflection were determined by stiffness index (SI) and augmentation index (AI). In the total sample, 45.8% had never smoked, 34.7% were former smokers, and 19.4% were current smokers. Median cumulative smoking exposure was 22.0 pack-years in current male smokers and 16.0 in current female smokers. In general, multivariable linear regression models adjusted for a comprehensive set of confounders revealed that smoking status, pack-years of smoking, and years since quitting smoking were dose-dependently associated with markers of arterial stiffness. In sex-specific analyses, these associations were overall more pronounced in men and SI was stronger related to the male sex, whereas differences between men and women in the case of AI appeared to be less substantial. DISCUSSION The present results indicate that chronic smoking is strongly and dose-dependently associated with increased arterial stiffness in a large population-based cohort regardless of sex but with a stronger association in men.
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Affiliation(s)
- Omar Hahad
- Department of Cardiology-Cardiology I, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstraße 1, 55131, Mainz, Germany. .,German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, Mainz, Germany.
| | - Volker H. Schmitt
- Department of Cardiology-Cardiology I, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstraße 1, 55131 Mainz, Germany ,German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, Mainz, Germany
| | - Natalie Arnold
- Department of Cardiology-Cardiology I, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstraße 1, 55131 Mainz, Germany ,German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, Mainz, Germany ,Department of Cardiology, German Center for Cardiovascular Research (DZHK), partner site Hamburg/Kiel/Luebeck, Hamburg, Germany
| | - Karsten Keller
- Department of Cardiology-Cardiology I, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstraße 1, 55131 Mainz, Germany ,Center for Thrombosis and Hemostasis, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany ,Medical Clinic VII, Department of Sports Medicine, University Hospital Heidelberg, Heidelberg, Germany
| | - Jürgen H. Prochaska
- German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, Mainz, Germany ,Center for Thrombosis and Hemostasis, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany ,Preventive Cardiology and Preventive Medicine, Department of Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Philipp S. Wild
- German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, Mainz, Germany ,Center for Thrombosis and Hemostasis, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany ,Preventive Cardiology and Preventive Medicine, Department of Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Andreas Schulz
- Preventive Cardiology and Preventive Medicine, Department of Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Karl J. Lackner
- German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, Mainz, Germany ,Institute of Clinical Chemistry and Laboratory Medicine, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Norbert Pfeiffer
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Irene Schmidtmann
- Institute of Medical Biostatistics, Epidemiology and Informatics, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Matthias Michal
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Jörn M. Schattenberg
- Metabolic Liver Research Program, I. Department of Medicine, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Oliver Tüscher
- Department of Psychiatry and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Andreas Daiber
- Department of Cardiology-Cardiology I, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstraße 1, 55131 Mainz, Germany ,German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, Mainz, Germany
| | - Thomas Münzel
- Department of Cardiology-Cardiology I, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstraße 1, 55131, Mainz, Germany. .,German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, Mainz, Germany.
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Robertson OC, Marceau K, Moding KJ, Knopik VS. Developmental pathways linking obesity risk and early puberty: The thrifty phenotype and fetal overnutrition hypotheses. DEVELOPMENTAL REVIEW 2022. [DOI: 10.1016/j.dr.2022.101048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Poredos P, Jezovnik MK. Preclinical carotid atherosclerosis as an indicator of polyvascular disease: a narrative review. ANNALS OF TRANSLATIONAL MEDICINE 2021; 9:1204. [PMID: 34430645 PMCID: PMC8350699 DOI: 10.21037/atm-20-5570] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Accepted: 06/29/2021] [Indexed: 12/15/2022]
Abstract
Carotid atherosclerotic lesions are correlated with atherosclerotic deterioration of the arterial wall in other vascular territories and with cardiovascular events. The detection of pre-symptomatic carotid lesions like intima-media thickness (IMT) and asymptomatic carotid plaques is possible by non-invasive ultrasound duplex scanning. Current measurement guidelines suggest an average measurement of IMT within 10 mm of the segment of the common carotid artery. The thickening of intima-media appears in a long subclinical period of atherosclerosis. Therefore, the determination of IMT has emerged as one of the methods for determining early structural deterioration of the arterial wall. A close interrelationship was shown between IMT and risk factors of atherosclerosis, their duration, and intensity. Different studies demonstrated that increased IMT is a powerful predictor of coronary, cerebrovascular, and peripheral arterial occlusive disease and their complication. A recent meta-analysis indicated a minimal improvement in the risk estimation of cardiovascular events after adding IMT to the Framingham Risk Score. These findings influenced the latest ACC/AHA guidelines which again recommend the use of carotid IMT measurement for individual risk assessment. The presence of atherosclerotic plaques indicates that the atherosclerotic process is already ongoing. The findings of different studies are equivocal that carotid plaques independently predict cardiovascular events and improve risk predictions for coronary artery disease when added to the Framingham Risk Score. However, besides the size of plaque and grade of stenosis, the structure of plaque calcification, vascularization, lipid core, and the surface of plaques are important indicators of related risks for cardiovascular events.
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Affiliation(s)
- Pavel Poredos
- Department of Vascular Disease, University Medical Centre Ljubljana, Ljubljana, Slovenia.,Department of Advanced Cardiopulmonary Therapies and Transplantation, The University of Texas Health Science Centre at Houston, Houston, TX, USA
| | - Mateja K Jezovnik
- Department of Advanced Cardiopulmonary Therapies and Transplantation, The University of Texas Health Science Centre at Houston, Houston, TX, USA
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7
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Kiriyama H, Kaneko H, Itoh H, Yoshida Y, Nakanishi K, Mizuno Y, Daimon M, Morita H, Yamamichi N, Komuro I. Effect of cigarette smoking on carotid artery atherosclerosis: a community-based cohort study. Heart Vessels 2019; 35:22-29. [PMID: 31222551 DOI: 10.1007/s00380-019-01455-5] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Accepted: 06/14/2019] [Indexed: 11/24/2022]
Abstract
Cigarette smoking is closely associated with the development of cardiovascular diseases. However, the relationship between cigarette smoking and subclinical atherosclerosis has not been fully studied. We sought to clarify the association between cigarette smoking and carotid intima-media thickness (cIMT) in a general Japanese population. Among 1,209 participants who received a medical check-up with cardiovascular examination at our institution, 450 participants (37.2%) were smokers (including both past and current smokers). We evaluated cIMT as a marker of subclinical atherosclerosis. The value of cIMT and rate of carotid plaque defined as IMT ≥ 1.1 mm did not differ between smokers and never smokers. However, the rate of carotid high-risk atheroma, defined as carotid artery atheroma including hypoechoic dominant and ulceration, was significantly higher among smokers than never smokers (30.4%, vs 23.6%, p = 0.009). Even after adjustment for covariates, cigarette smoking was independently associated with high-risk atheroma formation (odds ratio 1.384, 95% CI 1.019-1.880; p = 0.038). The value of cIMT and the rate of high-risk atheroma were significantly higher in smokers than never smokers in the subgroup of participants aged ≥ 60 years, whereas the rate of high-risk atheroma only was higher in smokers than never smokers in the subgroup of participants aged < 60 years. In conclusion, the development of high-risk carotid artery atheroma may precede the thickening of cIMT in cigarette smokers, which suggests the novel insight for the pathological mechanism underlying cardiovascular events and cigarette smoking.
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Affiliation(s)
- Hiroyuki Kiriyama
- Department of Cardiovascular Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Hidehiro Kaneko
- Department of Cardiovascular Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan. .,Department of Advanced Cardiology, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.
| | - Hidetaka Itoh
- Department of Cardiovascular Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Yuriko Yoshida
- Department of Cardiovascular Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Koki Nakanishi
- Department of Cardiovascular Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Yoshiko Mizuno
- Department of Cardiovascular Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.,Center for Epidemiology and Preventive Medicine, The University of Tokyo Hospital, Tokyo, Japan
| | - Masao Daimon
- Department of Cardiovascular Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.,Department of Clinical Laboratory, The University of Tokyo Hospital, Tokyo, Japan
| | - Hiroyuki Morita
- Department of Cardiovascular Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Nobutake Yamamichi
- Center for Epidemiology and Preventive Medicine, The University of Tokyo Hospital, Tokyo, Japan
| | - Issei Komuro
- Department of Cardiovascular Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
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8
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Is there a gender-specific association between asthma and carotid intima media thickness in Swiss adolescents? Eur J Pediatr 2018; 177:699-707. [PMID: 29411143 DOI: 10.1007/s00431-018-3107-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2017] [Revised: 01/21/2018] [Accepted: 01/23/2018] [Indexed: 01/06/2023]
Abstract
UNLABELLED Respiratory diseases are associated with increased cardiovascular risk in adults, but little is known on the early impact on the vasculature in youth. The SAPALDIA Youth study, the offspring study of the Swiss Study on Air Pollution and Lung and Heart Disease In Adults (SAPALDIA), investigated the association between physician-diagnosed asthma status and common carotid artery intima media thickness (CIMT). Offspring underwent standardized clinical protocols and provided information on early life factors, health, and lifestyle. The association between per subject averages of CIMT and asthma was estimated using mixed linear regression analyses adjusting for main confounders, testing for interaction with gender and age. Of 257 offspring (mean age 15 years, 53% female), 11.5% reported doctor-diagnosed asthma (male 17%, female 7%). Mean CIMT was significantly different by gender (male 0.53 mm (± 0.045), female 0.50 mm (± 0.048); p < 0.001). Interaction was highly significant by gender (p = 0.001) with significantly increased CIMT in asthmatic vs. non-asthmatics boys (difference 0.023 mm, 95% CI 0.003; 0.043), as compared to girls. CONCLUSION Our study suggests an increased risk for early vascular change in adolescent asthmatic boys. Whereas the small number of girls limits the interpretation, the result necessitates further research into sex-specific atherosclerotic burden related to respiratory health in adolescence. What is Known: • Evidence points to a significant impact of adult respiratory disease on cardiovascular health indicators as well as on endpoints. • Inflammation is a key pathway in vascular change across the life course. What is New: • We observe an adverse association between physician-diagnosed asthma and carotid intima media thickness in adolescent boys. • Albeit a limited number of asthmatic girls, we hypothesize the gender typical timing of asthma or a higher male cardiovascular vulnerability as possible explanations for the gender-specific results.
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9
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Poredos P. Intima-media thickness: indicator of cardiovascular risk and measure of the extent of atherosclerosis. Vasc Med 2016; 9:46-54. [PMID: 15230488 DOI: 10.1191/1358863x04vm514ra] [Citation(s) in RCA: 95] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
The measurement of intima-media thickness (IMT) of large superficial arteries, especially the carotid, using high-resolution B-mode ultrasonography has emerged as one of the methods of choice for determining the anatomic extent of atherosclerosis and for assessing cardiovascular risk. IMT measurement obtained by ultrasonography correlates very well with pathohistologic measurements and the reproducibility of this technique is good. Population studies have shown a strong correlation between carotid IMT and several cardiovascular risk factors, and it has also been found to be associated with the extent of atherosclerosis and end-organ damage of high-risk patients. Therefore, increased carotid IMT is a measure of athero-sclerotic burden and a predictor of subsequent events. Because of its quantitative value, carotid IMT measurement is more and more frequently used in clinical trials to test the effects of different preventive measures, including drugs. More recently, there has been interest in the clinical use of this technique for detecting preclinical (asymptomatic) atherosclerosis and for identifying subjects at high risk. Measurement of carotid IMT could influence a clinician to intervene with medication and to use more aggressive treatment of risk factors in primary prevention, and in patients with atherosclerotic disease in whom there is evidence of progression and extension of atherosclerotic disease. For more extensive use of this method in clinical practice a consensus concerning the standardization of methods of measurement and precise definition of threshold between normal and pathologic IMT value is urgently needed.
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Affiliation(s)
- Pavel Poredos
- Department for Vascular Disease, University Medical Centre, Ljubljana, Slovenia.
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10
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Dratva J, Caviezel S, Schaffner E, Bettschart R, Kuenzli N, Schindler C, Schmidt-Trucksäss A, Stolz D, Zemp E, Probst-Hensch N. Infectious diseases are associated with carotid intima media thickness in adolescence. Atherosclerosis 2015; 243:609-15. [PMID: 26545015 DOI: 10.1016/j.atherosclerosis.2015.10.021] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2015] [Revised: 10/04/2015] [Accepted: 10/17/2015] [Indexed: 01/28/2023]
Abstract
OBJECTIVE Inflammatory risk factors in childhood, e.g. obesity, impact on carotid artery intima media thickness (CIMT), an early indicator of atherosclerosis. Little is known on potential infectious origins in childhood. We investigated the association between number of reported different childhood infectious diseases and CIMT in adolescence. STUDY DESIGN 288 SAPALDIA offspring (8-21years) underwent a clinical examination in 2010-2011: anthropometry, blood pressure, CIMT, blood draw (cardiovascular biomarkers, cotinine). Offspring and parents gave information on individuals' and family health, child's vaccination status, infectious diseases and other early life factors. Life-time prevalence of bronchitis, pneumonia, tonsillitis, otitis, mononucleosis, meningitis, appendicitis, and scarlet fever were investigated, separately, and as cumulative infectious disease score. Multilevel adjusted linear regression analysis on the association between subjects' CIMT average and infectious diseases score was performed, stratifying by sex. RESULTS Youth (mean age 14.8 yrs; 53% female) reported on average 1.3 of the listed infectious diseases; 22% boys and 15% girls reported ≥3 infectious diseases (p = 0.136). Two-thirds were vaccinated according to recommendations (boys 56%, girls 61.5%, p = 0.567). Sex-stratified analyses yielded significantly increased CIMT in boys with ≥3 infectious diseases vs. none (0.046 mm, 95%CI 0.024; 0.068). In girls, the effect was of same direction but statistically non-significant (0.011 mm, 95%CI -0.015; 0.036). CONCLUSION The SAPALDIA Youth study complements current evidence on infectious origins of atherosclerosis in adults. The larger effects observed in boys may relate to a higher vulnerability of the vasculature and/or to infectious pathogens. Our data are suggestive of an early impact of childhood infectious diseases on vascular health.
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Affiliation(s)
- Julia Dratva
- Swiss Tropical and Public Health Institute, Basel, CH, Socinstrasse 57, CH-4002 Basel, Switzerland; University of Basel, CH, Petersplatz 1, CH-4031 Basel, Switzerland.
| | - Seraina Caviezel
- Swiss Tropical and Public Health Institute, Basel, CH, Socinstrasse 57, CH-4002 Basel, Switzerland; University of Basel, CH, Petersplatz 1, CH-4031 Basel, Switzerland; Department for Sport, Exercise and Health, Division Sports and Exercise Medicine, University of Basel, St. Jakob-Arena, Brüglingen 33, CH-4052 Basel, Switzerland
| | - Emmanuel Schaffner
- Swiss Tropical and Public Health Institute, Basel, CH, Socinstrasse 57, CH-4002 Basel, Switzerland; University of Basel, CH, Petersplatz 1, CH-4031 Basel, Switzerland
| | - Robert Bettschart
- Lungenpraxis Hirslanden Klinik Aarau, Schanzweg 7, CH-5000 Aarau, Switzerland
| | - Nino Kuenzli
- Swiss Tropical and Public Health Institute, Basel, CH, Socinstrasse 57, CH-4002 Basel, Switzerland; University of Basel, CH, Petersplatz 1, CH-4031 Basel, Switzerland
| | - Christian Schindler
- Swiss Tropical and Public Health Institute, Basel, CH, Socinstrasse 57, CH-4002 Basel, Switzerland; University of Basel, CH, Petersplatz 1, CH-4031 Basel, Switzerland
| | - Arno Schmidt-Trucksäss
- Department for Sport, Exercise and Health, Division Sports and Exercise Medicine, University of Basel, St. Jakob-Arena, Brüglingen 33, CH-4052 Basel, Switzerland
| | - Daiana Stolz
- Universitätsspital, Pneumologie, Basel CH, Petersgraben 4, CH-4031 Basel, Switzerland
| | - Elisabeth Zemp
- Swiss Tropical and Public Health Institute, Basel, CH, Socinstrasse 57, CH-4002 Basel, Switzerland; University of Basel, CH, Petersplatz 1, CH-4031 Basel, Switzerland
| | - Nicole Probst-Hensch
- Swiss Tropical and Public Health Institute, Basel, CH, Socinstrasse 57, CH-4002 Basel, Switzerland; University of Basel, CH, Petersplatz 1, CH-4031 Basel, Switzerland
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11
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Ueno M, Ohara S, Sawada N, Inoue M, Tsugane S, Kawaguchi Y. The association of active and secondhand smoking with oral health in adults: Japan public health center-based study. Tob Induc Dis 2015. [PMID: 26225132 PMCID: PMC4518564 DOI: 10.1186/s12971-015-0047-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Background Smoking is one of the major risk factors for oral diseases, and many studies have found that active smoking is closely associated with the prevalence or severity of periodontal disease and fewer remaining teeth. In contrast to the established association between active smoking and oral health, there have been very few studies investigating the effects of secondhand smoking on oral health, and whether secondhand smoking deteriorates oral health has not been fully clarified. The purpose of the present study was to examine whether active and secondhand smoking were associated with the prevalence of severe periodontal disease and number of teeth among Japanese adults. Methods Subjects were 1,164 dentate adults aged 55–75 years as of May 2005 who participated in both the Japan Public Health Center-Based Study Cohort I in 1990 and a dental survey in 2005. The dental survey was implemented in the Yokote health center jurisdiction, Akita Prefecture. Participating subjects completed a self-administered questionnaire and a clinical oral examination. The association of smoking status with prevalence of periodontal disease was analyzed using a logistic regression, and with number of teeth or functional tooth units of natural teeth (n-FTUs) using a generalized linear model. Results After adjusting for age, education level, history of diabetes, BMI, alcohol consumption, perceived mental stress, presence of a family dentist, and oral hygiene, the odds ratio (OR) of risk for periodontal disease in male subjects was significantly increased in non-smokers with secondhand smoking only at home (OR = 3.14, 95 % CI: 1.08−9.12, p = 0.036), non-smokers with secondhand smoking both at home and other places (OR = 3.61, 95 % CI: 1.33−9.81, p = 0.012) and current smokers (OR = 3.31, 95 % CI: 1.54−7.08, p = 0.002), compared to non-smokers without secondhand smoking. Further in men, current smokers had significantly fewer numbers of teeth (19.7 ± 6.82) and n-FTUs (4.92 ± 4.12) than non-smokers without secondhand smoking (22.2 ± 6.92, p = 0.014 and 6.56 ± 4.18, p = 0.007). Such significant relationships of smoking status with periodontal disease and dentition were not observed in women. Conclusions The present study indicates that active smoking as well as secondhand smoking may have harmful effects on periodontal health in men. Therefore, it is imperative for health and oral health professionals to enlighten people about the negative influence of smoking, not only on their own health but also on others’ health.
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Affiliation(s)
- Masayuki Ueno
- Department of Oral Health Promotion, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Satoko Ohara
- Department of Comprehensive Oral Health Care, Faculty of Dentistry, Tokyo Medical and Dental University, Tokyo, Japan
| | - Norie Sawada
- Epidemiology and Prevention Division, Research Center for Cancer Prevention and Screening, National Cancer Center, Tokyo, Japan
| | - Manami Inoue
- Epidemiology and Prevention Division, Research Center for Cancer Prevention and Screening, National Cancer Center, Tokyo, Japan ; AXA Department of Health and Human Security, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | - Shoichiro Tsugane
- Epidemiology and Prevention Division, Research Center for Cancer Prevention and Screening, National Cancer Center, Tokyo, Japan
| | - Yoko Kawaguchi
- Department of Oral Health Promotion, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
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12
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Suzuki K. Longitudinal analyses of childhood growth: evidence from Project Koshu. J Epidemiol 2014; 25:2-7. [PMID: 25283310 PMCID: PMC4275431 DOI: 10.2188/jea.je20140130] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2014] [Accepted: 07/29/2014] [Indexed: 11/27/2022] Open
Abstract
Recently, it has been suggested that fetal and infant environments are associated with childhood and adulthood health status, specifically regarding presence of obesity and chronic diseases. This concept is known as the "Developmental Origins of Health and Disease (DOHaD) hypothesis." Thus, it is necessary to collect information about the fetal and infancy periods in order to examine the association between fetal and infancy exposures and later growth. Based on the DOHaD hypothesis, childhood growth trajectories, which were described by multilevel analysis, might be important in examining the effects of early-life environment on later-life health. The author and colleagues examined the association between maternal smoking during pregnancy and fetal/childhood growth, specifically risk of childhood obesity, by using the dataset from an ongoing prospective cohort study called "Project Koshu," which enrolled pregnant women and their children from a rural area of Japan. Children born to smoking mothers were likely to have lower birth weights and, thereafter, to show an increase in body mass index compared to children of non-smoking mothers. Differences in pubertal growth patterns by gender and childhood weight status were then examined. Growth rate and height gain trajectories were similar between genders, although pubertal growth spurts were observed earlier in girls than in boys. The overweight/obese children grew faster than did the non-overweight children in the early pubertal stages, and the non-overweight children caught up and showed greater height gains at older ages. Because Project Koshu is ongoing, further studies examining new research questions will be conducted with larger sample sizes.
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Affiliation(s)
- Kohta Suzuki
- Department of Health Sciences, Interdisciplinary Graduate School of Medicine and Technology, University of Yamanashi
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13
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Fujii N, Brunt VE, Minson CT. Tempol improves cutaneous thermal hyperemia through increasing nitric oxide bioavailability in young smokers. Am J Physiol Heart Circ Physiol 2014; 306:H1507-11. [PMID: 24682395 DOI: 10.1152/ajpheart.00886.2013] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
We recently found that young cigarette smokers display cutaneous vascular dysfunction relative to nonsmokers, which is partially due to reduced nitric oxide (NO) synthase (NOS)-dependent vasodilation. In this study, we tested the hypothesis that reducing oxidative stress improves NO bioavailability, enhancing cutaneous vascular function in young smokers. Ten healthy young male smokers, who had smoked for 6.3 ± 0.7 yr with an average daily consumption of 9.1 ± 0.7 cigarettes, were tested. Cutaneous vascular conductance (CVC) during local heating to 42°C at a rate of 0.1°C/s was evaluated as laser-Doppler flux divided by mean arterial blood pressure and normalized to maximal CVC, induced by local heating to 44°C plus sodium nitroprusside administration. We evaluated plateau CVC during local heating, which is known to be highly dependent on NO, at four intradermal microdialysis sites with 1) Ringer solution (control); 2) 10 μM 4-hydroxy-2,2,6,6-tetramethylpiperidine-1-oxyl (tempol), a superoxide dismutase mimetic; 3) 10 mM N(ω)-nitro-l-arginine (l-NNA), a nonspecific NOS inhibitor; and 4) a combination of 10 μM tempol and 10 mM l-NNA. Tempol increased plateau CVC compared with the Ringer solution site (90.0 ± 2.3 vs. 77.6 ± 3.9%maximum, P = 0.028). Plateau CVC at the combination site (56.8 ± 4.5%maximum) was lower than the Ringer solution site (P < 0.001) and was not different from the l-NNA site (55.1 ± 4.6%maximum, P = 0.978), indicating the tempol effect was exclusively NO dependent. These data suggest that in young smokers, reducing oxidative stress improves cutaneous thermal hyperemia to local heating by enhancing NO production.
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Affiliation(s)
- Naoto Fujii
- Department of Human Physiology, The University of Oregon, Eugene, Oregon
| | - Vienna E Brunt
- Department of Human Physiology, The University of Oregon, Eugene, Oregon
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14
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Suzuki K, Sato M, Ando D, Kondo N, Yamagata Z. Differences in the effect of maternal smoking during pregnancy for childhood overweight before and after 5 years of age. J Obstet Gynaecol Res 2013; 39:914-21. [DOI: 10.1111/jog.12025] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2012] [Accepted: 11/08/2012] [Indexed: 11/26/2022]
Affiliation(s)
- Kohta Suzuki
- Department of Health Sciences; Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi; Chuo Yamanashi Japan
| | - Miri Sato
- Center for Birth Cohort Studies; Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi; Chuo Yamanashi Japan
| | - Daisuke Ando
- Department of Physical Education; National Defence Academy; Yokosuka Kanagawa Japan
| | - Naoki Kondo
- Department of Health Economics and Epidemiology Research; University of Tokyo School of Public Health; Tokyo Japan
| | - Zentaro Yamagata
- Department of Health Sciences; Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi; Chuo Yamanashi Japan
- Center for Birth Cohort Studies; Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi; Chuo Yamanashi Japan
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15
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Iwamoto Y, Maruhashi T, Fujii Y, Idei N, Fujimura N, Mikami S, Kajikawa M, Matsumoto T, Kihara Y, Chayama K, Noma K, Nakashima A, Higashi Y. Intima-Media Thickness of Brachial Artery, Vascular Function, and Cardiovascular Risk Factors. Arterioscler Thromb Vasc Biol 2012; 32:2295-303. [DOI: 10.1161/atvbaha.112.249680] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- Yumiko Iwamoto
- From the Department of Cardiovascular Medicine (Y.I., T.M., Y.F., N.I., N.F., S.M., M.K., T.M., Y.K.), Department of Medicine and Molecular Science, Graduate School of Biomedical Sciences (K.C.), and Department of Cardiovascular Regeneration and Medicine (K.N., Y.H.), Research Center for Radiation Genome Medicine, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan; and Division of Regeneration and Medicine (K.N., A.N., Y.H.), Hiroshima University Hospital,
| | - Tatsuya Maruhashi
- From the Department of Cardiovascular Medicine (Y.I., T.M., Y.F., N.I., N.F., S.M., M.K., T.M., Y.K.), Department of Medicine and Molecular Science, Graduate School of Biomedical Sciences (K.C.), and Department of Cardiovascular Regeneration and Medicine (K.N., Y.H.), Research Center for Radiation Genome Medicine, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan; and Division of Regeneration and Medicine (K.N., A.N., Y.H.), Hiroshima University Hospital,
| | - Yuichi Fujii
- From the Department of Cardiovascular Medicine (Y.I., T.M., Y.F., N.I., N.F., S.M., M.K., T.M., Y.K.), Department of Medicine and Molecular Science, Graduate School of Biomedical Sciences (K.C.), and Department of Cardiovascular Regeneration and Medicine (K.N., Y.H.), Research Center for Radiation Genome Medicine, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan; and Division of Regeneration and Medicine (K.N., A.N., Y.H.), Hiroshima University Hospital,
| | - Naomi Idei
- From the Department of Cardiovascular Medicine (Y.I., T.M., Y.F., N.I., N.F., S.M., M.K., T.M., Y.K.), Department of Medicine and Molecular Science, Graduate School of Biomedical Sciences (K.C.), and Department of Cardiovascular Regeneration and Medicine (K.N., Y.H.), Research Center for Radiation Genome Medicine, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan; and Division of Regeneration and Medicine (K.N., A.N., Y.H.), Hiroshima University Hospital,
| | - Noritaka Fujimura
- From the Department of Cardiovascular Medicine (Y.I., T.M., Y.F., N.I., N.F., S.M., M.K., T.M., Y.K.), Department of Medicine and Molecular Science, Graduate School of Biomedical Sciences (K.C.), and Department of Cardiovascular Regeneration and Medicine (K.N., Y.H.), Research Center for Radiation Genome Medicine, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan; and Division of Regeneration and Medicine (K.N., A.N., Y.H.), Hiroshima University Hospital,
| | - Shinsuke Mikami
- From the Department of Cardiovascular Medicine (Y.I., T.M., Y.F., N.I., N.F., S.M., M.K., T.M., Y.K.), Department of Medicine and Molecular Science, Graduate School of Biomedical Sciences (K.C.), and Department of Cardiovascular Regeneration and Medicine (K.N., Y.H.), Research Center for Radiation Genome Medicine, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan; and Division of Regeneration and Medicine (K.N., A.N., Y.H.), Hiroshima University Hospital,
| | - Masato Kajikawa
- From the Department of Cardiovascular Medicine (Y.I., T.M., Y.F., N.I., N.F., S.M., M.K., T.M., Y.K.), Department of Medicine and Molecular Science, Graduate School of Biomedical Sciences (K.C.), and Department of Cardiovascular Regeneration and Medicine (K.N., Y.H.), Research Center for Radiation Genome Medicine, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan; and Division of Regeneration and Medicine (K.N., A.N., Y.H.), Hiroshima University Hospital,
| | - Takeshi Matsumoto
- From the Department of Cardiovascular Medicine (Y.I., T.M., Y.F., N.I., N.F., S.M., M.K., T.M., Y.K.), Department of Medicine and Molecular Science, Graduate School of Biomedical Sciences (K.C.), and Department of Cardiovascular Regeneration and Medicine (K.N., Y.H.), Research Center for Radiation Genome Medicine, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan; and Division of Regeneration and Medicine (K.N., A.N., Y.H.), Hiroshima University Hospital,
| | - Yasuki Kihara
- From the Department of Cardiovascular Medicine (Y.I., T.M., Y.F., N.I., N.F., S.M., M.K., T.M., Y.K.), Department of Medicine and Molecular Science, Graduate School of Biomedical Sciences (K.C.), and Department of Cardiovascular Regeneration and Medicine (K.N., Y.H.), Research Center for Radiation Genome Medicine, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan; and Division of Regeneration and Medicine (K.N., A.N., Y.H.), Hiroshima University Hospital,
| | - Kazuaki Chayama
- From the Department of Cardiovascular Medicine (Y.I., T.M., Y.F., N.I., N.F., S.M., M.K., T.M., Y.K.), Department of Medicine and Molecular Science, Graduate School of Biomedical Sciences (K.C.), and Department of Cardiovascular Regeneration and Medicine (K.N., Y.H.), Research Center for Radiation Genome Medicine, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan; and Division of Regeneration and Medicine (K.N., A.N., Y.H.), Hiroshima University Hospital,
| | - Kensuke Noma
- From the Department of Cardiovascular Medicine (Y.I., T.M., Y.F., N.I., N.F., S.M., M.K., T.M., Y.K.), Department of Medicine and Molecular Science, Graduate School of Biomedical Sciences (K.C.), and Department of Cardiovascular Regeneration and Medicine (K.N., Y.H.), Research Center for Radiation Genome Medicine, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan; and Division of Regeneration and Medicine (K.N., A.N., Y.H.), Hiroshima University Hospital,
| | - Ayumu Nakashima
- From the Department of Cardiovascular Medicine (Y.I., T.M., Y.F., N.I., N.F., S.M., M.K., T.M., Y.K.), Department of Medicine and Molecular Science, Graduate School of Biomedical Sciences (K.C.), and Department of Cardiovascular Regeneration and Medicine (K.N., Y.H.), Research Center for Radiation Genome Medicine, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan; and Division of Regeneration and Medicine (K.N., A.N., Y.H.), Hiroshima University Hospital,
| | - Yukihito Higashi
- From the Department of Cardiovascular Medicine (Y.I., T.M., Y.F., N.I., N.F., S.M., M.K., T.M., Y.K.), Department of Medicine and Molecular Science, Graduate School of Biomedical Sciences (K.C.), and Department of Cardiovascular Regeneration and Medicine (K.N., Y.H.), Research Center for Radiation Genome Medicine, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan; and Division of Regeneration and Medicine (K.N., A.N., Y.H.), Hiroshima University Hospital,
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16
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Suzuki K, Kondo N, Sato M, Tanaka T, Ando D, Yamagata Z. Maternal smoking during pregnancy and childhood growth trajectory: a random effects regression analysis. J Epidemiol 2012; 22:175-8. [PMID: 22277789 PMCID: PMC3798597 DOI: 10.2188/jea.je20110033] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2011] [Accepted: 10/18/2011] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Although maternal smoking during pregnancy has been reported to have an effect on childhood overweight/obesity, the impact of maternal smoking on the trajectory of the body mass of their offspring is not very clear. Previously, we investigated this effect by using a fixed-effect model. However, this analysis was limited because it rounded and categorized the age of the children. Therefore, we used a random-effects hierarchical linear regression model in the present study. METHODS The study population comprised children born between 1 April 1991 and 31 March 1999 in Koshu City, Japan and their mothers. Maternal smoking during early pregnancy was the exposure studied. The body mass index (BMI) z-score trajectory of children born to smoking and non-smoking mothers, by gender, was used as the outcome. We modeled BMI trajectory using a 2-level random intercept and slope regression. RESULTS The participating mothers delivered 1619 babies during the study period. For male children, there was very strong evidence that the effect of age in months on the increase in BMI z-score was enhanced by maternal smoking during pregnancy (P < 0.0001). In contrast, for female children, there was only weak evidence for an interaction between age in months and maternal smoking during pregnancy (P = 0.054), which suggests that the effect of maternal smoking during pregnancy on the early-life BMI trajectory of offspring differed by gender. CONCLUSIONS These results may be valuable for exploring the mechanism of fetal programming and might therefore be clinically important.
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Affiliation(s)
- Kohta Suzuki
- Center for Birth Cohort Studies, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi, Yamanashi, Japan.
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17
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Gender differences in the association between maternal smoking during pregnancy and childhood growth trajectories: multilevel analysis. Int J Obes (Lond) 2010; 35:53-9. [PMID: 20921965 DOI: 10.1038/ijo.2010.198] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
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18
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Flouris AD, Vardavas CI, Metsios GS, Tsatsakis AM, Koutedakis Y. Biological evidence for the acute health effects of secondhand smoke exposure. Am J Physiol Lung Cell Mol Physiol 2010; 298:L3-L12. [DOI: 10.1152/ajplung.00215.2009] [Citation(s) in RCA: 70] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
A vast number of studies on the unfavorable effects of secondhand smoke (SHS) exist within the international literature, the majority of which evaluate longitudinal epidemiological data. Although limited, the experimental studies that assess the acute and short-term effects of exposure to SHS are also increasing in number. They include cellular, animal, and human studies that indicate a number of pathophysiological mechanisms through which the deleterious effects of SHS may arise. This current review evaluates the existing biological evidence regarding the acute health effects of SHS exposure. Analyses on the inhaled toxicants and the carcinogenicity of SHS are included as well as in-depth discussions on the evidence for acute SHS-induced respiratory, cardiovascular, metabolic, endocrine and immune effects, and SHS-induced influences on oxygen delivery and exercise. The influence of the length of exposure and the duration of the observed effects is also described. Moreover, recent findings regarding the underlying pathophysiological mechanisms related to SHS are depicted so as to generate models that describe the SHS-induced effects on different systems within the human body. Based on the presented biological evidence, it is concluded that brief, acute, transient exposures to SHS may cause significant adverse effects on several systems of the human body and represent a significant and acute health hazard. Future research directions in this area include research on the concentrations of tobacco smoke constituents in the alveolar milieu following SHS exposure, individual susceptibility to SHS, as well as the effects of SHS on neurobehavioral activity, brain cell development, synaptic development, and function.
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Affiliation(s)
- Andreas D. Flouris
- FAME Laboratory, Institute of Human Performance and Rehabilitation, Centre for Research and Technology Thessaly, Trikala; and
| | | | - Giorgos S. Metsios
- School of Sport, Performing Arts and Leisure, University of Wolverhampton, Wolverhampton, United Kingdom
| | - Aristidis M. Tsatsakis
- Centre of Toxicology Science and Research, School of Medicine, University of Crete, Iraklio; and
| | - Yiannis Koutedakis
- School of Sport, Performing Arts and Leisure, University of Wolverhampton, Wolverhampton, United Kingdom
- Department of Sport and Exercise Science, University of Thessaly, Trikala, Greece
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19
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Baldassarre D, Castelnuovo S, Frigerio B, Amato M, Werba JP, De Jong A, Ravani AL, Tremoli E, Sirtori CR. Effects of timing and extent of smoking, type of cigarettes, and concomitant risk factors on the association between smoking and subclinical atherosclerosis. Stroke 2009; 40:1991-8. [PMID: 19359639 DOI: 10.1161/strokeaha.108.543413] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND PURPOSE The purpose of this study was to evaluate the effects of timing and extent of smoking, type of cigarettes, and concomitant vascular risk factors (VRFs) on the association between smoking and carotid intima-media thickness (C-IMT) in a lipid clinic population. METHODS 1804 patients (869 men, age 21 to 85 year) participated in the study. Smoking habits were recorded and C-IMTs were measured by B-mode ultrasound. The associations of C-IMT with smoking status (never, former, and current) and with the cigarettes' content of tar, nicotine, and carbon monoxide (alone or combined to define "light" or "regular" cigarettes) as well as the interactions between smoking status, gender, and VRFs were evaluated before and after adjustment for confounders. RESULTS C-IMT was highest in current smokers, lower in former, and lowest in never smokers. C-IMT of former and current smokers differed only after data adjustment for variables describing the extent and timing of smoking exposure. C-IMT was positively related to the number of pack-years (number of cigarettes smoked per day [cigarettes/d] multiplied by number of years smoked/20) in both former and current smokers. There were no differences in C-IMT between smokers of cigarettes with high or low nicotine, tar, or carbon monoxide content. Both diabetes and hypertension interacted positively with smoking in determining C-IMTs. CONCLUSIONS In the present cross-sectional observational investigation, carried out in a cohort of patients attending a lipid clinic, consumption of light cigarettes does not reduce the atherogenic effect of smoking on C-IMT. The number of pack-years, cigarettes/d, and years of smoking are relevant covariates in evaluating the effects of smoking on vascular health. The presence of diabetes or hypertension strengthens the association between smoking and cardiovascular risk.
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Affiliation(s)
- Damiano Baldassarre
- E. Grossi Paoletti Center, Department of Pharmacological Sciences, University of Milan, Via Balzaretti 9, 20133, Milan, Italy.
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20
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Junyent M, Gilabert R, Núñez I, Corbella E, Cofán M, Zambón D, Ros E. Ecografía femoral en la evaluación de la aterosclerosis preclínica. Distribución de valores del grosor íntima-media y frecuencia de placas de ateroma en una cohorte comunitaria española. Med Clin (Barc) 2008; 131:566-71. [DOI: 10.1157/13128017] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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21
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Flouris AD, Metsios GS, Jamurtas AZ, Koutedakis Y. Sexual dimorphism in the acute effects of secondhand smoke on thyroid hormone secretion, inflammatory markers and vascular function. Am J Physiol Endocrinol Metab 2008; 294:E456-62. [PMID: 18073318 DOI: 10.1152/ajpendo.00699.2007] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Experimental evidence for the physiological effects of secondhand smoke (SHS) is limited, although it affects millions of people globally and its prevalence is increasing, despite currently adopted antismoking measures. Also, scarce evidence suggests that the effects of SHS may be more pronounced in men. We conducted a randomized single-blind crossover study to investigate the sex-specific SHS effects in a controlled simulated bar/restaurant environment on gonadal and thyroid hormones, inflammatory cytokines, and vascular function. Twenty-eight (women = 14) nonsmoking adults underwent a 1-h exposure to moderate SHS and a 1-h control trial. Serum and urine cotinine, gonadal and thyroid hormones, inflammatory cytokines, heart rate, and arterial blood pressure were assessed before exposure and immediately after in both trials. Results showed that testosterone (P = 0.019) and progesterone (P < 0.001) in men and 17beta-estradiol (P = 0.001) and progesterone (P < 0.001) in women were significantly decreased after SHS. In men, SHS was accompanied by increased free thyroxine (P < 0.001), triiodothyronine (P = 0.020), and decreased the triiodothyronine-to-free thyroxine ratio (P = 0.033). In women, significant SHS-induced change was observed only in free thyroxine (P = 0.010), with considerable sex variation in free thyroxine and triiodothyronine and a decrease in luteinizing hormone (P = 0.026) and follicle-stimulating hormone (P < 0.001). After SHS, IL-1beta (P = 0.001) and systolic blood pressure (P = 0.040) were increased in men but not women. We concluded that a 1-h SHS exposure at bar/restaurant levels is accompanied by decrements in gonadal hormones in both sexes and marked increases in thyroid hormone secretion, IL-1beta production, and systolic blood pressure in men.
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Affiliation(s)
- Andreas D Flouris
- Institute of Human Performance and Rehabilitation, Centre for Research and Technology-Thessaly, 32 Siggrou Street, Trikala, Greece.
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Pureza DYD, Sargentini L, Laterza R, Flores LJF, Irigoyen MC, Angelis KD. Efeitos cardiovasculares da abstinência do fumo no repouso e durante o exercício submáximo em mulheres jovens fumantes. REV BRAS MED ESPORTE 2007. [DOI: 10.1590/s1517-86922007000500003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJETIVO: O objetivo do presente estudo foi verificar o efeito da abstinência do fumo nas respostas cardiovasculares ao exercício físico progressivo submáximo em mulheres sedentárias fumantes. MÉTODOS: A pressão arterial sistólica (PAS) e diastólica (PAD) e a freqüência cardíaca (FC) foram medidas de forma não invasiva em mulheres jovens não fumantes (MNF, n = 7) e fumantes (MF, n = 7), sem e com abstinência do fumo por 24 horas, em repouso, durante a realização do teste submáximo em bicicleta ergométrica e na recuperação. RESULTADOS: Em repouso, a PAD e a FC foram maiores nas MF (76 ± 1mmHg e 86 ± 5bpm) quando comparadas com as MNF (68 ± 2mmHg e 72 ± 2bpm). Após 24 horas sem o tabaco essas medidas foram normalizadas. Durante o exercício, a PAS e a FC aumentaram nos grupos estudados. A PAD foi maior nas MF (~15%) em relação às MNF em todos os estágios do exercício. Na situação de abstinência, a PAD aumentou somente no último estágio de exercício. Na recuperação tanto a PAD quanto a FC foram maiores nas MF, na situação basal e com abstinência de 24h, quando comparadas as MNF. CONCLUSÃO: Estes resultados demonstram que mulheres jovens fumantes apresentam prejuízo em parâmetros hemodinâmicos em repouso e em resposta ao exercício submáximo, os quais, podem ser em parte revertidos pela abstinência em curto prazo do uso do tabaco.
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Wolf YG, Kobzantsev Z, Zelmanovich L. Size of normal and aneurysmal popliteal arteries: A duplex ultrasound study. J Vasc Surg 2006; 43:488-92. [PMID: 16520160 DOI: 10.1016/j.jvs.2005.11.026] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2005] [Accepted: 11/22/2005] [Indexed: 10/24/2022]
Abstract
OBJECTIVE To define diameter at three levels along the popliteal artery and its relation to the inflow arteries in the normal state and in popliteal aneurysms. METHODS The external diameter of the arteries was determined by duplex ultrasound scanning at the common femoral (CFA), superficial femoral artery (SFA), proximal popliteal artery (PPOP), mid-popliteal artery (MPOP), and distal popliteal artery (DPOP). Examinations were performed in 104 healthy men and 100 women. In addition, patients were screened for the presence of popliteal aneurysms (diameter >10 mm). Findings in healthy male subjects were compared with those with popliteal aneurysms. RESULTS Mean arterial diameters in normal men were larger than in women, but the SFA/CFA ratio was smaller in women (0.74 +/- 0.08 vs 0.78 +/- 0.09; P < .001) and the MPOP/SFA ratio was larger (0.98 +/- 0.11 vs 0.94 +/- 0.12; P = .001). In both genders, normal popliteal artery diameter was not uniform throughout its length, with PPOP and MPOP being nearly identical, and DPOP was smaller. MPOP diameter correlated most closely with SFA diameter (r = 0.51; P < .001) and less with height, weight and body surface area (r = 0.2 to 0.3) and was not associated with age or the presence of hypertension. In 27 men with 45 patent, fusiform popliteal aneurysms (10 to 44 mm) the site of maximal dilatation was in the region of the MPOP in 39 cases and near the PPOP in only 6 cases. The DPOP was never the largest segment and only in one case was it >10 mm. Arterial diameter in aneurysm patients was larger than normal at all levels but was greatest near the MPOP level (15.7 +/- 6.9). Popliteal-to-SFA diameter ratios were increased in the aneurysm group at all three levels but were greatest at the MPOP level (1.85 vs 0.94, P < .001). Comparing 15 popliteal aneurysms >20 mm with smaller ones, distal popliteal artery changed to the least extent but did increase in diameter (6.1 +/- 1.2 vs 7.0 +/- 1.4, P < .04). In larger aneurysms the MPOP/SFA ratio increased from 1.54 to 2.5 (P < .001). CONCLUSION The diameter of the normal popliteal artery is not uniform throughout its length. In popliteal aneurysms, the region of the MPOP is most commonly the largest diameter. The MPOP/SFA ratio is greater than normal in popliteal aneurysms and increases in larger aneurysms. DPOP does dilate but to a lesser extent then PPOP and MPOP, making endovascular repair anatomically feasible in most popliteal aneurysms.
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Affiliation(s)
- Yehuda G Wolf
- Department of Vascular Surgery, Tel Aviv Sourasky Medical Center, Isreal.
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Mahmud A, Feely J. Effects of passive smoking on blood pressure and aortic pressure waveform in healthy young adults--influence of gender. Br J Clin Pharmacol 2004; 57:37-43. [PMID: 14678338 PMCID: PMC1884425 DOI: 10.1046/j.1365-2125.2003.01958.x] [Citation(s) in RCA: 73] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
AIMS Passive smoking impairs the elasticity of the aorta in patients with coronary heart disease. We therefore studied the effect of passive smoking on wave reflection in the aorta, a marker of arterial stiffness, in healthy subjects. METHOD We examined the effects of acute exposure to passive smoking on blood pressure and the aortic pressure waveform in healthy young men (n = 10) and women (n = 11), aged 26 +/- 5 years (mean +/- SEM) compared with 12 healthy controls, aged 24 +/- 2 years (six female) who were exposed to room air. The aortic pressure waveform was derived with radial applanation tonometry (SphygmoCor, AtCor Medical, version 6.2) and the augmentation index, a measure of arterial wave reflection in the aorta, calculated. Blood pressure (Omron Model HEM-705 CP, Omron Corporation, Tokyo, Japan) and augmentation index were measured at baseline, 15, 30 and 60 min after exposure to environmental tobacco smoke (carbon monoxide 25-30 p.p.m. for 60 min) or room air. RESULTS Passive smoking was associated with an increase in brachial (124 +/- 4-137 +/- 3 mmHg, P < 0.01) and aortic systolic blood pressure (110 +/- 3-123 +/- 4 mmHg, P < 0.01) at 60 min in the male subjects only. The augmentation index increased from -1.7 +/- 5 to 14 +/- 5 at 60 min (P < 0.001) only in the male subjects. The transit time of the pulse did not change significantly. The change in augmentation index was independent of the increase in blood pressure. Brachial and aortic diastolic blood pressure and heart rate did not change significantly in either male or female subjects. No haemodynamic changes were observed in the control group. CONCLUSIONS Acute exposure to passive smoking has a deleterious effect on the arterial pressure waveform in healthy young males but not in females, suggesting a possible protection of female gender from functional changes in arteries.
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Affiliation(s)
- Azra Mahmud
- Department of Pharmacology and Therapeutics, Trinity College Dublin and Hypertension Clinic, St James's Hospital, Dublin 8, Ireland
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Abstract
Cigarette smoking as an addictive habit has accompanied human beings for more than 4 centuries. It is also one of the most potent and prevalent environmental health risks human beings are exposed to, and it is responsible for more than 1000 deaths each day in the United States. With recent research progress, it becomes clear that cigarette smoking can cause almost all major diseases prevalent today, such as cancer or heart disease. These detrimental effects are not only present in active smokers who choose the risk, but also to innocent bystanders, as passive smokers, who are exposed to cigarettes not-by-choice. While the cigarette-induced harm to human health is indiscriminate and severe, the degree of damage also varies from individual to individual. This intersubject variability in cigarette-induced pathologies is partly mediated by genetic variants of genes that may participate in detoxification process, eg, cytochrome P450 (CYP), cellular susceptibility to toxins, such as p53, or disease development. Through population studies, we have learned that certain CYP1A1 variants, such as Mspl polymorphism, may render the carriers more susceptible to cigarette-induced lung cancer or severe coronary atherosclerosis. The endothelial nitric oxide synthase intron 4 rare allele homozygotes are more likely to have myocardial infarction if they also smoke. In vitro experimental approach has further demonstrated that cigarettes may specifically regulate these genes in genotype-dependent fashion. While we still know little about genetic basis and molecular pathways for cigarette-induced pathological changes, understanding these mechanisms will be of great value in designing strategies to further reduce smoking in targeted populations, and to implement more effective measures in prevention and treatment of cigarette-induced diseases.
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Affiliation(s)
- Xing Li Wang
- Vascular Genetics Laboratory, Department of Genetics, Southwest Foundation for Biomedical Research, San Antonio, TX 78227, USA.
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Karvonen J, Kauma H, Kervinen K, Ukkola O, Rantala M, Päivänsalo M, Savolainen MJ, Kesäniemi YA. Apolipoprotein E polymorphism affects carotid artery atherosclerosis in smoking hypertensive men. J Hypertens 2002; 20:2371-8. [PMID: 12473860 DOI: 10.1097/00004872-200212000-00015] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Smoking is a risk factor for increased carotid artery intima-media thickness (IMT). The apolipoprotein E (apoE) 4 allele has been associated with cardiovascular diseases, but the role of apoE in regard to intima-media thickness (IMT) has remained controversial. The objective was to investigate whether there is some gene-environment interaction between smoking and apoE polymorphism. DESIGN Cross-sectional case-control study. METHODS IMTs of 511 hypertensive and control men were measured ultrasonographically and the apoE genotypes were determined. Genotypes with the 4 allele were pooled into one group and the genotypes without it into another. RESULTS A significant interaction between the 4 allele and smoking affecting IMT was observed among the hypertensive smokers, as assessed by analysis of covariance. The mean carotid IMT was significantly greater (1.01 versus 0.90 mm, P = 0.003) in the 4 carriers than in the subjects without 4 among the hypertensive smokers. The number of plaques was also significantly higher. No differences were found in the other subjects (hypertensive non-smokers or controls). Linear regression analysis indicated that the 4 allele was an independent determinant of IMT in the hypertensive smokers but not in the other subjects. The estimated average effect of the 4 allele on the mean IMT in the hypertensive smokers was 0.088 mm (P < 0.001). In the oldest age group, the interaction of smoking and 4 was also seen in the control subjects. CONCLUSION The findings suggest that the 4 carriers are particularly susceptible to the atherogenic effects of smoking. This interaction is particularly clear in hypertensive subjects.
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Affiliation(s)
- Jarkko Karvonen
- Department of Internal Medicine, University of Oulu, PO Box 5000, FIN-90014, Finland.
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Djoussé L, Myers RH, Province MA, Hunt SC, Eckfeldt JH, Evans G, Peacock JM, Ellison RC. Influence of apolipoprotein E, smoking, and alcohol intake on carotid atherosclerosis: National Heart, Lung, and Blood Institute Family Heart Study. Stroke 2002; 33:1357-61. [PMID: 11988615 DOI: 10.1161/01.str.0000014325.54063.1a] [Citation(s) in RCA: 75] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND PURPOSE Apolipoprotein E (apoE) isoforms and lifestyle factors play an important role in the development of coronary heart disease. The association of apoE and carotid atherosclerosis remains controversial. METHODS We investigated the relation of apoE, cigarette smoking, alcohol drinking, and their interaction with carotid atherosclerosis on 544 individuals free of coronary heart disease in the National Heart, Lung, and Blood Institute (NHLBI) Family Heart Study. Atherosclerotic lesions of the carotid arteries were detected through high-resolution ultrasound. RESULTS Subjects in the apoE4 group had lower blood pressure, lower high-density lipoprotein cholesterol, and higher low-density lipoprotein cholesterol. In a multivariate logistic regression model, apoE isoforms and alcohol consumption were not significantly associated with the prevalence odds of carotid atherosclerosis (P=0.94 and 0.98, respectively, for trend). In contrast, compared with those who never smoked, the prevalence odds ratios for carotid atherosclerosis were 1.7 [95% confidence interval (CI),1.1 to 2.7], 2.8 (95% CI, 1.2 to 6.2), and 1.9 (95% CI, 0.7 to 5.5) for former smokers, current smokers of 1 to 20 cigarettes per day, and current smokers of >20 cigarettes day, respectively (P=0.0018 for trend). We did not find evidence of an interaction between apoE and alcohol consumption. Our data suggested a synergistic effect between the apoE allele epsilon(4) and smoking on carotid atherosclerosis: odds ratios were 1.7 (95% CI, 0.8 to 3.6) for smoking alone, 1.0 (95% CI, 0.6 to 1.8) for epsilon4 alone, and 3.7 (95% CI, 1.1 to 3.6) for the joint presence of the apoE allele epsilon4 and smoking. CONCLUSIONS Smoking but not alcohol consumption or ApoE is associated with an increased odds of carotid atherosclerosis. Our data suggest a synergistic effect between the apoE allele epsilon4 and smoking on carotid atherosclerosis.
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Affiliation(s)
- Luc Djoussé
- Section of Preventive Medicine and Epidemiology, Evans Department of Medicine, Boston University School of Medicine, Boston, Mass 02118, USA.
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