The pathophysiology of cigarette smoking and cardiovascular disease: an update

J Am Coll Cardiol. 2004 May 19;43(10):1731-7. doi: 10.1016/j.jacc.2003.12.047.

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.

Publication types

  • Review

MeSH terms

  • Arteriosclerosis / etiology
  • Arteriosclerosis / physiopathology
  • Blood Vessels / drug effects
  • Cardiovascular Diseases / etiology
  • Cardiovascular Diseases / physiopathology*
  • Coronary Thrombosis / etiology
  • Coronary Thrombosis / physiopathology
  • Female
  • Humans
  • Male
  • Oxidative Stress / drug effects
  • Smoke / adverse effects
  • Smoking / adverse effects*
  • Tobacco
  • Tobacco Smoke Pollution / adverse effects

Substances

  • Smoke
  • Tobacco Smoke Pollution