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The pathophysiology of cigarette smoking and cardiovascular disease
Open accessAbstract
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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“Other evidence161 shows that the effects diminish with increasing exposure for active smoking, a pattern incorporated into our exposure– response curves.”
In the citing paper
“Mechanisms have been elucidated through observational cohort studies, experimental observations, and laboratory studies in humans and animals, 225,227 -229 and point towards the effect of smoking on endothelial function, 230,231 oxidative processes, 232 platelet function, 233 fibrinolysis, inflammation, 234 -238 and modification of lipids and vasomotor function.”
From European Guidelines on cardiovascular disease prevention in clinical practice (version 2012) (2012) · cites this paper as [227]
In the citing paper
“Most current evidence suggests that nicotine exposure from smoking has only minor effects on the atherosclerotic process, 227,245”
From European Guidelines on cardiovascular disease prevention in clinical practice (version 2012) (2012) · cites this paper as [227]
In the citing paper
“Notably, lifestyle risk factors, including dietary habits, physical inactivity, smoking, and adiposity, strongly influence the established cardiovascular risk factors and also affect novel pathways of risk such as inflammation/oxidative stress, endothelial function, thrombosis/coagulation, and arrhythmia.”
From Beyond Established and Novel Risk Factors: Lifestyle Risk Factors for Cardiovascular Disease (2008) · cites this paper as [38]
In the citing paper
“In patients with established cardiovascular disease, physical activity reduces angina symptoms, benefits heart failure, decreases claudication, and lowers mortality after myocardial infarction.38”
From Beyond Established and Novel Risk Factors: Lifestyle Risk Factors for Cardiovascular Disease (2008) · cites this paper as [38]
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“Consistent with these pleiotropic benefits, physical activity and fitness are associated with 30% to 50% lower risk of cardiovascular events.38,40,67”
From Beyond Established and Novel Risk Factors: Lifestyle Risk Factors for Cardiovascular Disease (2008) · cites this paper as [38]
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Inoue, T., Oku, K., Kimoto, K., Takao, M., Nomoto, J., D, K. H. M., Kono, S., & Arakawa, K. (2008) · Cardiology · doi:10.1159/000176904 · Cited by 33
Model studies linking carbon monoxide and/or nicotine to arteriosclerosis and cardiovascular disease
Astrup, P. B., & Kjeldsen, K. (1979) · Preventive Medicine · doi:10.1016/0091-7435(79)90006-9 · Cited by 29
Inhalation of carbon monoxide does not accelerate arteriosclerosis in cockerels
Penn, A. L., Currie, J., & Snyder, C. A. (1992) · European Journal of Pharmacology Environmental Toxicology and Pharmacology · doi:10.1016/0926-6917(92)90025-8 · Cited by 24
Pellegrini, M. (2001) · Cardiovascular Research · doi:10.1016/s0008-6363(01)00381-9 · Cited by 23
Effects of transdermal nicotine treatment on structure and function of coronary artery bypass grafts
Clouse, W. D., Yamaguchi, H., Phillips, M. R., Hurt, R. D., Fitzpatrick, L. A., Moyer, T. P., Rowland, C. C., Schaff, H. V., & Miller, V. M. (2000) · Journal of Applied Physiology · doi:10.1152/jappl.2000.89.3.1213 · Cited by 22
Prothrombotic determinants of coronary atherothrombosis
Ruberg, F. L., & Loscalzo, J. (2002) · Vascular Medicine · doi:10.1191/1358863x02vm448ra · Cited by 22
Smokers Lack Morning Increase in Platelet Sensitivity to Nitric Oxide
Sawada, M., Kishi, Y., Numano, F., & Isobe, M. (2002) · Journal of Cardiovascular Pharmacology · doi:10.1097/00005344-200210000-00010 · Cited by 21
Yamaguchi, Y., Kagota, S., Haginaka, J., & Kunitomo, M. (2000) · Environmental Toxicology and Pharmacology · doi:10.1016/s1382-6689(00)00050-8 · Cited by 16
Srivastava, S. K., Barua, R. S., Saha, D. C., Eales‐Reynolds, L., DeVoe, M. C., & Ambrose, J. A. (2003) · Journal of the American College of Cardiology · doi:10.1016/s0735-1097(03)82432-4 · Cited by 9
Self-citation
Flagged first, then by citations
2 of the 111 references couldn’t be matched to a known paper.
Cited by
Sorted by citations
Raza, H., John, A., & Nemmar, A. (2013) · Cellular Physiology and Biochemistry · doi:10.1159/000350087 · Cited by 47,311
Lim, S. S., Vos, T., Flaxman, A. D., Danaei, G., Shibuya, K., Adair-Rohani, H., AlMazroa, M. A., Amann, M., Anderson, H. R., Andrews, K. G., et al. (2012) · The Lancet · doi:10.1016/s0140-6736(12)61766-8 · Cited by 11,805
European Guidelines on cardiovascular disease prevention in clinical practice (version 2012)
Authors/Task Force Members:, Perk, J., De Backer, G., Gohlke, H., Graham, I., Reiner, Ž., Verschuren, M., Albus, C., Benlian, P., Boysen, G., et al. (2012) · European Heart Journal · doi:10.1093/eurheartj/ehs092 · Cited by 8,490
European guidelines on cardiovascular disease prevention in clinical practice: executive summary
Graham, I., Atar, D., Borch‐Johnsen, K., Boysen, G., Burell, G. K., Cífková, R., Dallongeville, J., Backer, G. D., Ebrahim, S. B. J., Gjelsvik, B., et al. (2007) · European Heart Journal · doi:10.1093/eurheartj/ehm316 · Cited by 3,865
Graham (2007) · doi:10.1097/01.hjr.0000277983.23934.c9 · Cited by 1,647
Metadata
- Authors
- Ambrose, J. A., & Barua, R. S.
- Affiliations
- Saint Vincent's Catholic Medical Center (US)
- Icahn School of Medicine at Mount Sinai (US)
- Corresponding author
- Ambrose, John A
- Venue
- Journal of the American College of Cardiology
- Publisher
- Elsevier BV
- Published
- 2004-05
- Volume
- 43
- Issue
- 10
- Pages
- 1731-1737
- ISSN
- 0735-1097 (ISSN-L)
- OpenAlex
- W1559813904
- Cited by
- 2,394
- References
- 111
- Citations by year
- 2026: 127 · 2025: 153 · 2024: 141 · 2023: 123 · 2022: 130 · 2021: 151 · 2020: 153 · 2019: 120 · 2018: 115 · 2017: 114 · 2016: 110 · 2015: 107 · 2014: 129 · 2013: 119 · 2012: 112
- FWCI
- 6.01
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Journal of the American College of Cardiology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Smoking Behavior and Cessation
- Health Sciences › Medicine › Physiology (medical) › Nitric Oxide and Endothelin Effects
- Health Sciences › Medicine › Biochemistry (medical) › Antioxidant Activity and Oxidative Stress
- Keywords
- cigarette smoking, cardiovascular disease, atherosclerosis, endothelial dysfunction, thrombosis, passive smoking, oxidative stress, LDL oxidation, inflammation, dose-response relationship
- MeSH terms
- Arteriosclerosis, Blood Vessels, Cardiovascular Diseases, Coronary Thrombosis, Female, Humans, Male, Smoke, Smoking, Nicotiana, Tobacco Smoke Pollution, Oxidative Stress
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
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