Long-term Smoking Cessation May Reverse Artery Stiffness

"Smoking is a major risk factor, not only for lung disease and cancer, but also for heart attack, stroke and heart failure," said lead author Noor Ahmed Jatoi, M.B.B.S., D.C.N., D.M.M.D. "Our group has previously shown that smoking a single cigarette, passive or second-hand smoking and chronic smoking all lead to stiffer arteries, which in turn increase resistance in the blood vessels and, therefore, increase the work the heart must do."

However, it was not clear if smoking cessation would be associated with reduced arterial stiffness. Stiffness in the arteries can increase blood pressure and is associated with increased risk of cardiovascular events.

The researchers studied 554 people (average age 47, 56 percent female) who had high blood pressure but had never been treated for it. Researchers divided the subjects into: current smokers (150), ex-smokers (136) and never-smokers (268).

"We categorized ex-smokers according to how long they were off cigarettes -- under one year, more than one but less than 10 years and more than 10 years of smoking cessation," said Jatoi, a Ph.D. student in clinical pharmacology at Trinity Health Sciences Centre and Hypertension Clinic at St. James's Hospital, Trinity College Dublin (University of Dublin), Ireland.

Researchers used Arterial Pulse Wave Analysis, a technology that measures arterial stiffness. They found that current and ex-smokers of only one year had significantly higher stiffness measurements compared with non-smokers. In ex-smokers, duration of smoking cessation was directly related to improvement in arterial stiffness. They found some improvement after one to 10 years, but arterial stiffness parameters only reached normal levels after more than a decade of smoking cessation.

"Our study reinforces the message that smoking cessation is an important step smokers can take to enhance the quality and length of their lives. It shows both the unhealthy effects of smoking and the benefit of smoking cessation on the arterial wall," he said. "The longer one stops smoking the better." However, researchers noted that results need to be confirmed in a prospective, longitudal study -- one that follows patients over time.

Co-authors are Paula Jerrard-Dunne, M.D.; John Feely, M.D. and senior author Azra Mahmud, M.D., Ph.D.