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Pathophysiological effect of cigarette smoking and nicotine on cardiovascular disease. HR, heart rate; BP, blood pressure; NO, nitrogen monoxide. Figure reprinted with permission from Salahuddin S, Prabhakaran D, Roy A. Pathophysiological mechanisms of tobacco-related CVD. Global Heart. 2012;7(2):113-119.

Pathophysiological effect of cigarette smoking and nicotine on cardiovascular disease. HR, heart rate; BP, blood pressure; NO, nitrogen monoxide. Figure reprinted with permission from Salahuddin S, Prabhakaran D, Roy A. Pathophysiological mechanisms of tobacco-related CVD. Global Heart. 2012;7(2):113-119.

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Cigarette smoking is a major risk factor for cardiovascular disease (CVD) and the leading avoidable cause of death worldwide. Exposure to secondhand smoke (SHS) increases the risk of CVD among non-smokers. Smoking cessation benefits all smokers, regardless of age or amount smoked. The excess risk of CVD is rapidly reversible, and stopping smoking a...

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... The effects of cigarette smoking on CVD are mediated through three principal constituents: nicotine, carbon monoxide (CO), and oxidant gases. (Figure 2) Other authors have described in details the biochemical mechanisms of nicotine on the cardiovas- cular system, 31,32 we will here summarize the main mechanisms. ...

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... Smoking increases the risk of at least 17 human cancers and induces cell mutations and DNA methylation (6). What's worse, smoking is also associated with cardiovascular disease (CVD) (7), tuberculosis infection and death (8), gastroesophageal reflux disease (9), low quality of life, and depression (10). ...
... However, life and work stress (25) occur when balancing the relationship, it is possible for people to relieve stress through smoking. Maybe the young are more addicted to smoking as a consequence of depression (7,26,27) and stress (25,28,29) from family, society, or emotion dysregulation (30,31). Implementing the decompression of the whole society, resisting the temptation of tobacco and developing good living habits can help reduce relapse to a certain extent. ...
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Background Tobacco use is still highly prevalent globally in spite of the tobacco control efforts made by the governments. In view of the harm of smoking and relapse after smoking cessation, the purpose of this study is to establish a competitive risk model to determine potential risk factors for smoking relapse.Methods The population-based cohort of ex-smokers over the age of 18 years was obtained from the China Family Panel Studies (CFPS) database from 2010 to 2018. Competing risk models were conducted to identify the risk factors for relapse.ResultsA total of 1,019 subjects were included in this study, of which 311 (30.52%) subjects relapsed during the follow-up period. A multivariate analysis indicated that age < 40 years [hazard ratio (HR) 19.142; 95% CI: 10.641–34.434, p < 0.01], cohabitation (HR: 1.422; 95% CI: 1.081–1.87, p = 0.01), and often depression [HR 1.422; 95% CI, (1.081–1.87), p = 0.01] were associated with a great risk of relapse while the age of quitting smoking < 60 years (HR: 0. 436; 95% CI: 0.229–0.831, p < 0.01) and joining the Chinese Communist Party (CCP) (HR 0.611; 95% CI: 0.397–0.939, p = 0.03) were reduced risk factors for relapse.Conclusions Approximately 3 in 10 ex-smokers were observed to relapse. There are various risk factors for relapse as well. In the face of such a serious situation, it is urgent to take action to control smoking.
... It encompassed several CVD categories (e.g., dysrhythmias, ischemic, and non-ischemic heart disease) [5]. Therefore, it is pivotal to continue efforts of the primary and secondary prevention measures various lifestyle modifications, e.g., weight and diet optimization, increase in physical activity, and smoking cessation [6][7][8]. ...
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There is a pressing need to identify novel antiplatelet agents, an alternative to acetylsalicylic acid and thieno-pyridines, to broaden the prevention of cardiovascular events, the leading cause of global morbidity and mortality. Invertebrate coelomocytes structurally and functionally resemble the thrombocyte-like cells of vertebrates; therefore, the coelomic fluid in which they are suspended may contain agents controlling their clumping abilities. However, whether coelomocytes-free coelomic fluid may also affect human platelet activities was not a subject of any study. This study aimed to screen the in vitro antiplatelet and anticoagulant activities of the polysaccharide-protein complex from Dendrobaena veneta coelomic fluid (25-100 µg/mL) (PPC-DV). All tested fluid concentrations induced significant (42.4-52.5%) inhibition of adenosine-5 ′-diphosphate (ADP)-induced aggregation of human platelets at a level comparable to that of 140 µmol/L acetylsalicylic acid. Its relevant antiplatelet effect (27.2-45.9%) was also evidenced in the thrombin receptor-activating peptide-6 (TRAP-6) assay. Moreover, 50 and 100 µg/mL of PPC-DV inhibited arachidonic acid-inducible aggregation. No coagulo-pathic or cytotoxic effects of PPC-DV were observed. The study indicates that PPC-DV, at a concentration of at least 50 µg/mL, exerts a favorable antiplatelet effect by targeting at least three pathways (P2Y 12 receptor, cyclooxygenase-1, and protease-activated receptor-1), justifying further experimental and clinical investigations on its use in cardiovascular disease prevention.
... Cigarette smoke includes nicotine, carbon monoxide, and oxidant gases, elevating myocardial oxygen demand, reducing myocardial oxygen supply, and driving oxidative stress, which finally results in atherothrombosis, myocardial ischemia, and acute coronary syndrome [42]. Smoking information is used for the binary categorized form (current smoking or not) [43], ternary categorical form (non-, ex-, and current smoker) [44], and continuous variable (pack years) [45]. ...
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Obesity and overweight status are primary risk factors for stroke. A relative small number of studies has analyzed the association of abdominal obesity, a crucial indicator for insulin resistance with stroke, compared to general obesity. We aimed to reveal 31,490 records from the Korea National Health and Nutrition Examination Survey (KNHANES). Logistic regression was used to identify the association of abdominal obesity with the risk of stroke. For the multivariate model, covariates were determined based on the cardio-cerebro vascular prediction models. In the sex-specific multivariate logistic regression analysis (including age, antihypertensive drug, diabetes, current smoking, and systolic blood pressure as confounders), the elevated waist circumference (WC) in women was significantly associated with the increased risk for stroke. In case of the categorized form of WC, we discerned the non-linear relationships between WC and the stroke status. The sex-specific associations between the abdominal obesity and stroke status were shown and their relationship pattern exhibited non-linear relationships.
... For analysis of overall risk factor management: adjusted for age, sex, education attainment (less than high school, high school or further education), family history of diabetes (yes, no), family history of CVD (yes, no), alcohol consumption, baseline BMI, BMI change during follow-up, active smoking (never, former, current smoking), and passive smoking exposure in childhood and adulthood and leading formation of atheroma [39], and these shared pathogenic pathways may underlie the interplay between smoking and diabetes on CVD. In addition, smoking is independently associated with the devastating cardiovascular health consequences for people with diabetes [39,40]. Therefore, the benefits of ideal management of other risk factors may not fully outweigh the smoking-related cardiovascular risk. ...
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Background Whether smoking modifies the associations of diabetes and risk factor management with subsequent risk of cardiovascular disease (CVD), and whether the smoking related CVD risk differs among people with and without diabetes are unclear. This study aimed to examine the associations and interactions of smoking, diabetes, and risk factor management in relation to incident CVD. Methods This nationwide, population-based, prospective cohort study of 20 communities from various geographic regions recruited adults aged 40 years or older during 2011–2012. The follow-up survey was conducted between 2014 and 2016. This study included 126,181 participants who were free from CVD at baseline. Results Study participants included 19,397 current smokers (15.4%), 6,049 former smokers (4.8%), and 100,735 never smokers (79.8%). Mean (SD) age ranged from 55.8 (8.6) years to 60.7 (9.1) years. Compared with never smokers, heavy smokers exhibited a greater risk of CVD events among participants with diabetes (multivariable-adjusted hazard ratio [HR], 1.45; 95% CI, 1.17–1.78) than among participants without diabetes (HR, 1.20; 95% CI, 1.01–1.42; P for interaction = 0.006). Compared with participants without diabetes, participants with diabetes who were never smokers and had 5 or more controlled risk factors showed no significantly excess CVD risk (HR, 0.93; 95% CI, 0.71–1.22), but the cardiovascular benefits from risk factor management were counteracted among participants with diabetes who were current smokers (HR, 1.28; 95% CI, 0.77–2.14) or former smokers (HR, 1.22; 95% CI, 0.66–2.28). Conclusions Smoking and diabetes interacted with each other in relation to increased risk of CVD events, and the beneficial effect of risk factor management on CVD risk among participants with diabetes was attenuated by current or former smoking.
... Tobacco use is an independent risk factor for CVD and approximately 29% of tobacco related deaths are caused by coronary artery disease (Rigotti & Clair, 2013). Although initially thought to be a safer alternative to smoking, e-cigarette users inhale harmful chemicals and nicotine, which are (Favaloro et al., 2013). ...
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Cardiovascular disease is the leading cause of death worldwide. In this study, we assessed factors related to cardiovascular disease risk and outcomes among sexual minorities (SM). Data from multiple waves of the PATH study were used in this analysis. Multivariable regression models were used to assess the association between sexual identity and: tobacco or e-cigarette use, adverse cardiovascular events, and age at first diagnosis of adverse cardiovascular disease events. In our sample (N = 23,205), 1,660 (7.15%) participants identified as SM. SM men, relative to heterosexual men, are more likely to be diagnosed with high blood pressure (aRR = 1.27; 95% CI 1.10, 1.47), high cholesterol (aRR = 1.32; 95% CI: 1.12, 1.55), congestive heart failure (aRR = 2.29; 95% CI 1.13, 4.65), stroke (aRR = 2.39; 95% CI: 1.14, 5.04), heart attack (aRR = 2.40; 95% CI 1.42, 4.04), and other heart conditions (aRR = 1.52; 95% CI: 1.06, 2.18). Although no simple differences were observed among SM women compared to heterosexual women, SM women were more likely to be diagnosed at a younger age for high blood pressure (aRR = -0.69; 95% CI − 1.08, − 0.29), high cholesterol (aRR = -0.77; 95% CI − 1.15, − 0.38), stroke (aRR = − 1.04; 95% CI − 1.94, − 0.13), and heart attack (aRR = − 1.26; 95% CI − 2.42, − 0.10). SM men were only diagnosed at a younger age for stroke (aRR = − 1.18; 95% CI − 2.06, − 0.30). Compared to heterosexuals, sexual minorities are at higher risk for cardiovascular disease, more likely to develop cardiovascular disease at an earlier age, and more likely to use tobacco products. Future research should focus on decreasing cardiovascular risk among sexual minorities including reducing tobacco use and stress. Screening recommendations for sexual minority populations should also be reviewed in light of a growing body of literature suggesting elevated risk from a young age.
... Thirty years of scientific research have proven cigarette smoking (CS) as the main cause of lung cancer (Schwartz and Cote, 2016), as a promoter of pathologies of the respiratory and cardiovascular systems (Rigotti and Clair, 2013) and as one of the major risk factors for neuro-inflammatory and neurovascular disorders by supporting oxidative stress and inflammation (Aseervatham et al., 2017). Furthermore, CS is involved in several malignancies and intestinal inflammatory disorders such as Crohn's disease (CD) (Verschuere et al., 2012a). ...
... CS is the main cause of several pathologies (Rigotti and Clair, 2013;Schwartz and Cote, 2016;Aseervatham et al., 2017), and numerous molecules present in cigarettes or generated by their combustion produce cell damage through different mechanisms. Over the past decade, evidence of a close relationship between CS and IBDs has accumulated, prompting us to investigate the mechanisms of action of smoking by means of animal models. ...
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Cigarette smoking (CS) is the cause of several organ and apparatus diseases. The effects of smoke in the gut are partially known. Accumulating evidence has shown a relationship between smoking and inflammatory bowel disease, prompting us to investigate the mechanisms of action of smoking in animal models. Despite the role played by neuropeptides in gut inflammation, there are no reports on their role in animal models of smoking exposure. The hormone relaxin has shown anti-inflammatory properties in the intestine, and it might represent a putative therapy to prevent gut damage caused by smoking. Presently, we investigate the effects of chronic smoke exposure on inflammation, mucosal secretion, and vasoactive intestinal peptide (VIP) and substance P (SP) expressions in the ileum and colon of guinea pigs. We also verify the ability of relaxin to counter the smoke-induced effects. Smoke impacted plasma carbon monoxide (CO). In the ileum, it induced inflammatory infiltrates, fibrosis, and acidic mucin production; reduced the blood vessel area; decreased c -kit-positive mast cells and VIP-positive neurons; and increased the SP-positive nerve fibers. In the colon, it reduced the blood vessel area and the goblet cell area and decreased c -kit-positive mast cells, VIP-positive neurons, and SP-positive nerve fibers. Relaxin prevented most of the smoking-induced changes in the ileum, while it was less effective in the colon. This study shows the diverse sensitivity to CS between the ileum and the colon and demonstrates that both VIP and SP are affected by smoking. The efficacy of relaxin proposes this hormone as a potential anti-inflammatory therapeutic to counteract gut damage in humans affected by inflammatory bowel diseases.
... Cessation of smoking is a key component of CVD prevention or reduction, and additionally, significantly lowers post-surgical pulmonary complications if achieved more than eight weeks before elective AAA repair versus quitting short-term [200,201]. A wellbalanced diet reduces CVD events and improves outcomes, and was suggested to be even more effective in reducing obesity compared to exercising [202,203]. ...
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Despite declining incidence and mortality rates in many countries, the abdominal aortic aneurysm (AAA) continues to represent a life-threatening cardiovascular condition with an overall prevalence of about 2–3% in the industrialized world. While the risk of AAA development is considerably higher for men of advanced age with a history of smoking, screening programs serve to detect the often asymptomatic condition and prevent aortic rupture with an associated death rate of up to 80%. This review summarizes the current knowledge on identified risk factors, the multifactorial process of pathogenesis, as well as the latest advances in medical treatment and surgical repair to provide a perspective for AAA management.
... Cigarette smoke contains numerous compounds, many of which have toxic and deleterious effect on the vascular system of the human body (4). According to a World Health Organization report, cigarette smoking contributes to 10-30% of all cardiovascular deaths worldwide (5), and several epidemiological surveys have reported that smoking is also strongly associated with ocular vascular diseases, such as retinal ischemia and anterior ischemic optic neuropathy (6). ...
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Purpose: To evaluate the changes in the retinal microvasculature and its reactivity in chronic cigarette smokers. Methods: Thirty-four male chronic cigarette smokers and 18 male non-smokers were enrolled. Optical coherence tomography angiography was used to measure the perfused retinal vessel densities (PVDs) of the peripapillary and parafoveal areas at baseline and during phase IV of the Valsalva maneuver (VM-IV). Systemic blood pressure and intraocular pressure were also measured. Results: The baseline PVD in the peripapillary area of the smokers was significantly lower than the non-smokers (59.56 ± 2.26% vs. 61.67 ± 3.58%, respectively; P = 0.005). However, there was no significant difference in the foveal avascular zone or parafoveal PVD between the two groups. During VM-IV, the peripapillary PVD of the smokers decreased by 1.13 ± 3.50%, which was significantly less than that of the non-smokers (−3.83 ± 4.26%, P < 0.05). Similarly, the parafoveal PVD of the smokers decreased by 5.49 ± 9.70%, which was significantly less than the percentage change of the non-smokers (−13.01 ± 8.39%, P < 0.05). There was no significant difference in the percentage change in systemic blood pressure parameters between the two groups. Conclusion: The retinal microvasculature and its reactivity were impaired in chronic smokers compared with non-smokers. The extent of impairment differed among different regions of the fundus.
... Tobacco use, a leading cause of premature death from CVD and the cause of coronary heart disease, cerebrovascular disease, aortic aneurysm, and heart failure [38,39], was more prevalent in the Veteran group pre-COVID compared to non-Veterans. This study's findings are similar to other studies showing increased tobacco use in Veterans compared to civilians [13,40]. ...
Article
BACKGROUND AND AIMS Pandemics have previously resulted in increased cardiovascular morbidity and mortality. It is unclear if the effects of the COVID-19 pandemic will be amplified in individuals at high risk for cardiovascular disease, such as military populations, resulting in augmented cardiovascular events in Veterans. The purpose of this study was to determine if traditional behavioral risk factors for cardiovascular disease are amplified due to the COVID-19 pandemic and if risk factors are more prevalent in Veterans compared to non-Veterans. METHODS AND RESULTS Thirty-two student Veterans and 46 non-Veteran students between the ages of 18 and 35 completed a Qualtrics self-report questionnaire assessing health behaviors, physical activity, and mental health both before and during COVID-19. Veterans displayed worse pre-COVID cardiovascular health behaviors such as poor sleep habits, greater use of tobacco, alcohol, and energy drinks, and lower values of social engagement compared to non-Veterans. Many health behaviors remained unchanged in student Veterans during the pandemic. The non-Veteran group exhibited augmentation of cardiovascular health behaviors during COVID-19, shown through the worsening sleep habits, increased anxiety, and reduced physical activity. CONCLUSION Student Veterans demonstrate heightened risk for cardiovascular disease based on the pre-COVID elevation of behavioral risk factors. These behavioral factors continued to remain elevated during the COVID-19 pandemic. Non-Veteran students displayed amplification of behavioral risk factors for cardiovascular disease due to the COVID-19 pandemic. These results highlight the need for resources and interventions for our student veterans and suggest long-term cardiovascular consequences for all students who suffered through the COVID-19 pandemic.
... However, in the context of young adults <40 years, the prevalence of hypertension (overall 5.8%) in males is 7.06% and females is 3.5% (N=6143 Smoking cessation is a key component of primary and secondary CVD prevention strategies, but chewing tobacco receives less attention despite the availability of proven evidences that it improves overall CVD risks following cessation. [33][34] Limitation This retrospective study has been conducted for limited population (across geography and ethnicity) using a novel approach, predominantly from hospitals based wellness and healthy individual's health check up. To overcome the limitation, this model is being evaluated through an ongoing prospective observational study in 9 institutions across India, covering all geographical, ethnic and socio economic diversities. ...
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Cardiovascular diseases (CVD) are one of the most prevalent diseases in India amounting for nearly 30% of total deaths. A dearth of research on CVD risk scores in Indian population, limited performance of conventional risk scores and inability to reproduce the initial accuracies in randomized clinical trials – has led to this study on large-scale patient data. The objective is to develop an Artificial Intelligence based Risk Score (AICVD) to predict CVD Event (e.g. Acute MI / ACS) in next 10 years and compare the model with the Framingham Heart Risk Score (FHRS) and QRisk3. Our study included 31,599 participants aged 18-91 years from 2009 - 2018 in six Apollo Hospitals in India. A multi-step risk factors selection process using Spearman correlation coefficient and propensity score matching yielded 21 risk factors. A Deep Learning Hazard Model was built on risk factors to predict event occurrence (classification) and time to event (hazard model) using multi-layered neural network. Further, the model was validated with independent retrospective cohorts of participants from India and the Netherlands and compared with FHRS and QRisk3. The Deep Learning Hazard model had a good performance (AUC 0.853). Validation and comparative results showed AUCs between 0.84 to 0.92 with better Positive Likelihood Ratio (AICVD-6.16 to FHRS–2.24 and QRisk3–1.16) and Accuracy (AICVD– 80.15% to FHRS 59.71% and QRisk3 51.57%). In the Netherlands cohort, AICVD also outperformed the Framingham Heart Risk Model (AUC - 0.737 vs 0.707). This study concludes that the novel AI based CVD risk score has a higher predictive performance for cardiac events than conventional risk scores.