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Scientific article
Open access
English

Associations Between Cardiovascular Risk Factors, Inflammation, and Progression of Carotid Atherosclerosis Among Smokers

Published inNicotine & tobacco research, vol. 18, no. 6, p. 1533-1538
Publication date2016-06-16
First online date2015-11-16
Abstract

Introduction: The high risk of cardiovascular events in smokers requires adequate control of other cardiovascular risk factors (CVRFs) to curtail atherosclerosis progression. However, it is unclear which CVRFs have the most influence on atherosclerosis progression in smokers.

Methods: In 260 smokers aged 40-70 included in a smoking cessation trial, we analyzed the association between traditional CVRFs, high-sensitivity C-reactive protein (hs-CRP), smoking cessation and 3-year progression of carotid intima-media thickness (CIMT, assessed by repeated ultrasound measurements) in a longitudinal multivariate model.

Results: Participants (mean age 52 years, 47% women) had a mean smoking duration of 32 years with a median daily consumption of 20 cigarettes. Baseline CIMT was 1185 μm (95% confidence interval [CI]: 1082-1287) and increased by 93 μm (95% CI: 25-161) and 108 μm (95% CI: 33-183) after 1 and 3 years, respectively. Age, male sex, daily cigarette consumption, systolic blood pressure (SBP), but neither low-density lipoprotein cholesterol nor hs-CRP, were independently associated with baseline CIMT (all P ≤ .05). Baseline SBP, but neither low-density lipoprotein cholesterol nor hs-CRP, was associated with 3-year atherosclerosis progression (P = .01 at 3 years). The higher the SBP at baseline, the steeper was the CIMT increase over 3-year follow-up. We found an increase of 26 μm per each 10-mmHg raise in SBP at 1 year and an increase of 39 μm per each 10 mmHg raise in SBP at 3 years. Due to insufficient statistical power, we could not exclude an effect of smoking abstinence on CIMT progression.

Conclusion: Control of blood pressure may be an important factor to limit atherosclerosis progression in smokers, besides support for smoking cessation.

Implications: Among 260 smokers aged 40-70 years with a mean smoking duration of 32 years, baseline SBP was associated with atherosclerosis progression over 3 years, as measured by CIMT (P = .01 at 3 years), independently of smoking variables and other CVRFs. The higher the SBP at baseline, the steeper was the CIMT increase over 3-year follow-up. Our findings emphasize the importance of focusing not only on smoking cessation among smokers, but to simultaneously control other CVRFs, particularly blood pressure, in order to prevent future cardiovascular disease.

eng
Keywords
  • Adult
  • Aged
  • Blood Pressure
  • C-Reactive Protein
  • Carotid Artery Diseases / complications
  • Carotid Artery Diseases / epidemiology
  • Female
  • Humans
  • Inflammation
  • Male
  • Middle Aged
  • Risk Factors
  • Smokers / statistics & numerical data
  • Smoking / epidemiology
Affiliation Not a UNIGE publication
Research group
Funding
Citation (ISO format)
ZINGG, Sarah et al. Associations Between Cardiovascular Risk Factors, Inflammation, and Progression of Carotid Atherosclerosis Among Smokers. In: Nicotine & tobacco research, 2016, vol. 18, n° 6, p. 1533–1538. doi: 10.1093/ntr/ntv255
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ISSN of the journal1462-2203
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