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      Daily assessment of arterial distensibility in a pediatric population before and after smoking cessation

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          Abstract

          OBJECTIVES:

          Cigarette smoking is an important modifiable cardiovascular risk factor associated with increased stiffness of the large arteries in adulthood. This study aimed to 1) evaluate arterial distensibility and echocardiographic measures in adolescent smokers before and after participation in a successful smoking cessation program and to 2) compare the findings obtained with data from a control population of healthy non-smokers.

          METHODS:

          A total of 31 young smoking subjects (58.1% male; range: 11-18 years old; mean: 16.5±1.4 years old; mean tobacco consumption: 2.6±0.6 years) were examined before commencing and after taking part for at least 1 year in a smoking cessation program (mean: 1.4±0.3 years). Arterial stiffness was measured using the previously validated QKd 100-60 method. Twenty-four-hour ambulatory blood pressure monitoring and transthoracic echocardiography were also performed.

          RESULTS:

          (Smokers before abuse cessation vs. smokers after abuse cessation) systolic blood pressure: p<0.004; diastolic blood pressure: p<0.02; mean blood pressure: p<0.01; QKd 100-60 value: 183±5 vs. 196±3 msec, p<0.009; p = ns for all echocardiographic parameters. (Smokers after abuse cessation vs. controls) systolic blood pressure: p<0.01; diastolic blood pressure: p<0.03; mean blood pressure: p<0.02; QKd 100-60 value: 196±3 vs. 203±2 msec, p<0.04; p<0.02, p<0.01, and p<0.05 for the interventricular septum, posterior wall, and left ventricular mass, respectively.

          CONCLUSIONS:

          Despite successful participation in a smoking cessation program, arterial distensibility improved but did not normalize. This finding underlines the presence of the harmful effect of arterial rigidity in these individuals, despite their having quit smoking and their young ages, thus resulting in the subsequent need for a lengthy follow-up period.

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          Most cited references134

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          Passive smoking and impaired endothelium-dependent arterial dilatation in healthy young adults.

          Passive smoking has been linked to an increased risk of dying from atherosclerotic heart disease. Since endothelial dysfunction is an early feature of atherogenesis and occurs in young adults who actively smoke cigarettes, we hypothesized that passive smoking might also be associated with endothelial damage in healthy young-adult nonsmokers. We studied 78 healthy subjects (39 men and 39 women) 15 to 30 years of age (mean +/- SD, 22 +/- 4): 26 control subjects who had never smoked or had regular exposure to environmental tobacco smoke, 26 who had never smoked but had been exposed to environmental tobacco smoke for at least one hour daily for three or more years, and 26 active smokers. Using ultrasonography, we measured the brachial-artery diameter under base-line conditions, during reactive hyperemia (with flow increase causing endothelium-dependent dilatation), and after sublingual administration of nitroglycerin (an endothelium-independent dilator). Flow-mediated dilatation was observed in all control subjects (8.2 +/- 3.1 percent; range, 2.1 to 16.7) but was significantly impaired in the passive smokers (3.1 +/- 2.7 percent; range, 0 to 9; P < 0.001 for the comparison with the controls) and in the active smokers (4.4 +/- 3.1 percent; range, 0 to 10; P < 0.001 for the comparison with the controls; P = 0.48 for the comparison with the passive smokers). In the passive smokers, there was an inverse relation between the intensity of exposure to tobacco smoke and flow-mediated dilatation (r = -0.67, P < 0.001). In contrast, dilatation induced by nitroglycerin was similar in all groups. Passive smoking is associated with dose-related impairment of endothelium-dependent dilatation in healthy young adults, suggesting early arterial damage.
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            Use and interpretation of ambulatory blood pressure monitoring: recommendations of the British hypertension society.

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              • Record: found
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              • Article: not found

              Cigarette Smoking, Cardiovascular Disease, and Stroke

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                Author and article information

                Journal
                Clinics (Sao Paulo)
                Clinics (Sao Paulo)
                Clinics
                Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo
                1807-5932
                1980-5322
                April 2014
                : 69
                : 4
                : 219-224
                Affiliations
                [I ]University of Cagliari, Department of Medical Sciences “M. Aresu”, Unit of Cardiology and Angiology, Cagliari, Italy.
                [II ]University of Cagliari, Department of Surgery, Section of Neonatal Intensive Care Unit and Puericulture, Cagliari, Italy.
                [III ]University of Cagliari, Department of Medical Sciences “M. Aresu”, Sport Physiology Laboratory, Cagliari, Italy.
                Author notes

                Bassareo PP and Fanos V conceived and designed the study, analyzed and interpreted the data, and prepared the manuscript. Bassareo PP and Crisafulli A performed the experiment and critically revised the manuscript. Crisafulli A participated in patient enrollment. Mercuro G critically revised the final manuscript version.

                E-mail: piercard@ 123456inwind.it Tel.: 39 070 6754953
                Article
                cln_69p219
                10.6061/clinics/2014(04)01
                3971354
                b0ac03cc-7943-46ec-bc9b-e56305ca25b4
                Copyright © 2014 Hospital das Clínicas da FMUSP

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 5 August 2013
                : 27 August 2013
                : 27 August 2013
                Page count
                Pages: 6
                Categories
                Clinical Science

                Medicine
                qkd interval,atherosclerosis,smoking,adolescence,prevention
                Medicine
                qkd interval, atherosclerosis, smoking, adolescence, prevention

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