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Gu Y, Li Z, Han X, Liu J, Li Y, Zhang W, Lv N, Dang A. Smoking, Alcohol Consumption, and Risk of Arterial Stiffness: A Two-Sample Mendelian Randomization Study. Rev Cardiovasc Med 2024; 25:255. [PMID: 39139409 PMCID: PMC11317346 DOI: 10.31083/j.rcm2507255] [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: 01/03/2024] [Revised: 01/31/2024] [Accepted: 02/06/2024] [Indexed: 08/15/2024] Open
Abstract
Background While observational studies have demonstrated connections between cigarette smoking, alcohol consumption, and arterial stiffness, establishing a causal relationship has proven challenging because of potential confounding factors. To address this problem, we employed a two-sample Mendelian randomization approach. Methods We selected genetic instruments for these risk factors from genome-wide association studies encompassing 3,383,199 individuals at the genome-wide significance level (p < 5 × 10 - 9 ). Arterial stiffness data were acquired from the UK Biobank, which included 127,121 participants. Our primary analysis utilized the inverse variance-weighted method to explore causality. To confirm our results' robustness, we conducted sensitivity analyses using Egger regression, the weighted median method, and Mendelian Randomization Pleiotropy RESidual Sum and Outlier (MR-PRESSO). Results Our analysis revealed a significant association between genetic inclination to smoking initiation and an increase in the arterial stiffness index ( β = 0.11; 95% confidence interval [CI], 0.06 to 0.16; p = 1.95 × 10 - 5 ). Additionally, there was a suggestive connection between genetically predicted number of cigarettes per day and the arterial stiffness index ( β = 0.05; 95% CI, 5.25 × 10 - 4 to 0.10; p = 4.75 × 10 - 2 ). No causal relationships were observed between the genetically predicted age of smoking initiation, smoking cessation, or alcohol consumption and the risk of arterial stiffness index. Conclusions This Mendelian randomization study indicates that smoking initiation is likely a causative risk factor for arterial stiffness. However, further research is needed to determine if the quantity of daily cigarettes directly contributes to arterial stiffness development. Regarding alcohol consumption, age of smoking initiation, and smoking cessation, there was insufficient evidence to establish causality.
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Affiliation(s)
- Yingzhen Gu
- Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Science and Peking Union Medical College, 100037 Beijing, China
| | - Zuozhi Li
- Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Science and Peking Union Medical College, 100037 Beijing, China
| | - Xiaorong Han
- Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Science and Peking Union Medical College, 100037 Beijing, China
| | - Jinxing Liu
- Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Science and Peking Union Medical College, 100037 Beijing, China
| | - Yifan Li
- Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Science and Peking Union Medical College, 100037 Beijing, China
| | - Wei Zhang
- Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Science and Peking Union Medical College, 100037 Beijing, China
| | - Naqiang Lv
- Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Science and Peking Union Medical College, 100037 Beijing, China
| | - Aimin Dang
- Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Science and Peking Union Medical College, 100037 Beijing, China
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Lee HJ, Choi JW. Association between waist circumference change after smoking cessation and incidence of hypertension in Korean adults. Public Health 2024; 229:73-79. [PMID: 38402666 DOI: 10.1016/j.puhe.2024.01.028] [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: 08/09/2023] [Revised: 12/14/2023] [Accepted: 01/26/2024] [Indexed: 02/27/2024]
Abstract
OBJECTIVES This study investigates the association between smoking cessation and hypertension incidence, as well as the association between waist circumference change after smoking cessation and hypertension incidence. STUDY DESIGN This was a nationwide population-based cohort study. METHODS We used the Korean Health Screening Cohort data and included 158,505 participants who had undergone two or more health examinations between 2008 and 2011, with follow-ups throughout 2019. Smoking cessation and waist changes were captured based on difference between first and follow-up screening dates. Hazard ratio (HR) and 95% confidence interval (CI) for hypertension risk were estimated using multivariable Cox proportional hazard regression models. RESULTS There were 31,270 cases of hypertension during a median follow-up of 8.50 years. After adjusting for potential confounding factors, HR for hypertension were 1.01 (95% CI: 0.97-1.05), 0.91 (95% CI: 0.87-0.95), and 0.88 (95% CI: 0.85-0.91) for recent quitters, long-term quitters, and non-smokers, respectively, compared with current smokers. HR for hypertension, compared with current smokers, were 0.89 (95% CI: 0.84-0.94), 0.91 (95% CI: 0.85-0.97), and 0.99 (95% CI: 0.91-1.08) for long-term quitters with no waist gain, long-term quitters with waist gain of 0.1-5.0 cm, and long-term quitters with waist gain of ≥5.0 cm, respectively. CONCLUSIONS Long-term smoking cessation was significantly associated with decreased risk of hypertension, and long-term smoking cessation with no waist gain or less than 5.0 cm of waist gain was significantly associated with decreased risk of hypertension. However, more than 5.0 cm of waist gain can attenuate the effect of long-term smoking cessation on lowering the risk of hypertension.
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Affiliation(s)
- H J Lee
- Department of Statistics and Data Science, Yonsei University, Seoul, Republic of Korea
| | - J W Choi
- Health Insurance Research Institute, National Health Insurance Service, Wonju, Republic of Korea.
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Goksu K, Vural A, Kahraman AN, Aslan IK. Evaluation of common carotid artery wall stiffness by shear wave elastography in smokers and non-smokers. Tob Induc Dis 2024; 22:TID-22-49. [PMID: 38463751 PMCID: PMC10921918 DOI: 10.18332/tid/185300] [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: 09/30/2023] [Revised: 12/27/2023] [Accepted: 02/23/2024] [Indexed: 03/12/2024] Open
Abstract
INTRODUCTION Smoking is one of the most important preventable causes of cardiovascular diseases. Vascular disease caused by smoking is associated with vascular endothelial damage, platelet aggregation, and adhesion. In our study, we examined the effect of chronic smoking on vessel wall stiffness in smokers and control group by measuring carotid artery wall stiffness by shear wave ultrasonography. METHODS Sixty-two smokers of similar ages and genders, and 67 people who never smoked in the last ten years were included as the control group in this cross-sectional study. Arterial wall stiffness over the common carotid arteries of all participants was measured by shear wave elastography (SWE). In addition, each patient's blood pressure, fasting blood glucose, body mass index (BMI), HDL and LDL cholesterol measurements were recorded. RESULTS Arterial wall stiffness values in smokers were found to be statistically significantly higher than in non-smokers. The mean of SWE measurements of the smokers was 47.3 ± 6.2 kPa, and that of the control group was 42.9 ± 4 kPa. The mean values of HDL and LDL of the smokers were 46.9 ± 5.6 mg/dL and 147.3 ± 9.3 mg/dL, respectively, and those of the control group were 50.3 ± 5.1 mg/dL and 136.9 ± 5.9 mg/dL. The LDL cholesterol values were statistically significantly higher in smokers compared to the control group, and HDL cholesterol values were statistically significantly lower in smokers. CONCLUSIONS In our study, the arterial wall stiffness values measured by the SWE technique were higher in smokers than non-smokers.
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Affiliation(s)
- Kamber Goksu
- Department of Radiology, Fatih Sultan Mehmet Training and Research Hospital, University of Health Sciences, Istanbul, Türkiye
| | - Ahmet Vural
- Department of Radiology, Fatih Sultan Mehmet Training and Research Hospital, University of Health Sciences, Istanbul, Türkiye
| | - Ahmet N. Kahraman
- Department of Radiology, Fatih Sultan Mehmet Training and Research Hospital, University of Health Sciences, Istanbul, Türkiye
| | - Isil K. Aslan
- Department of Neurology, Fatih Sultan Mehmet Training and Research Hospital, University of Health Sciences, Istanbul, Türkiye
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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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Angoff R, Mosarla RC, Tsao CW. Aortic Stiffness: Epidemiology, Risk Factors, and Relevant Biomarkers. Front Cardiovasc Med 2021; 8:709396. [PMID: 34820427 PMCID: PMC8606645 DOI: 10.3389/fcvm.2021.709396] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Accepted: 09/30/2021] [Indexed: 12/19/2022] Open
Abstract
Aortic stiffness (AoS) is a maladaptive response to hemodynamic stress and both modifiable and non-modifiable risk factors, and elevated AoS increases afterload for the heart. AoS is a non-invasive marker of cardiovascular health and metabolic dysfunction. Implementing AoS as a diagnostic tool is challenging as it increases with age and varies amongst races. AoS is associated with lifestyle factors such as alcohol and smoking, as well as hypertension and comorbid conditions including metabolic syndrome and its components. Multiple studies have investigated various biomarkers associated with increased AoS, and this area is of particular interest given that these markers can highlight pathophysiologic pathways and specific therapeutic targets in the future. These biomarkers include those involved in the inflammatory cascade, anti-aging genes, and the renin-angiotensin aldosterone system. In the future, targeting AoS rather than blood pressure itself may be the key to improving vascular health and outcomes. In this review, we will discuss the current understanding of AoS, measurement of AoS and the challenges in interpretation, associated biomarkers, and possible therapeutic avenues for modulation of AoS.
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Affiliation(s)
- Rebecca Angoff
- Cardiovascular Division, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, United States
| | - Ramya C Mosarla
- Division of Cardiology, Department of Medicine, New York University Langone Health, New York, NY, United States
| | - Connie W Tsao
- Cardiovascular Division, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, United States
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Kim HL, Weber T. Pulsatile Hemodynamics and Coronary Artery Disease. Korean Circ J 2021; 51:881-898. [PMID: 34595882 PMCID: PMC8558570 DOI: 10.4070/kcj.2021.0227] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 07/22/2021] [Accepted: 07/26/2021] [Indexed: 12/12/2022] Open
Abstract
Coronary artery disease (CAD) is the leading cause of human death and has a high prevalence throughout the world. Therefore, it is important to detect CAD early and to apply individualized therapy according to the patients' risk. There is an increasing interest in pulsatile arterial hemodynamics in the cardiovascular area. Widely used measurements of arterial pulsatile hemodynamics include pulse pressure, pulse wave velocity and augmentation index. Here, we will review underlying pathophysiology linking the association of arterial pulsatile hemodynamics with CAD, and the usefulness of the measurements of pulsatile hemodynamics in the prediction of future cardiovascular events of CAD patients. Clinical and therapeutic implications will be also addressed.
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Affiliation(s)
- Hack-Lyoung Kim
- Division of Cardiology, Department of Internal Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea
| | - Thomas Weber
- Department of Cardiology, Klinikum Wels-Grieskirchen GmbH, Wels, Austria.
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