Smoking cigarettes is like putting your blood vessels into a time machine headed into the future. As people age, the walls of their arteries gradually thicken. Research published in the AHA journal Circulation shows that cigarette smoking accelerates this process by more than a decade. By adding the equivalent of 10 years of aging to their arteries, smokers are increasing their risk of stroke and heart attack. Grethe S. Tell, Ph.D.,M.P.H., professor of epidemiology at Bowman Gray School of Medicine in Winton-Salem, N.C., and her colleagues, analyzed data from ultrasound exams of the carotid arteries of 5,116 people older than 64.

They found "clinically significant" (50 percent or more of the artery's width) narrowing of these major blood vessels in 4.4 percent of people who had never smoked, 7.3 percent of former smokers and 9.5 percent of current smokers. Ultrasound imaging is a non-invasive technique that uses high frequency sound waves to help produce images of the body's interior. Located in the neck, the carotid arteries carry blood to the brain. If narrowed by atherosclerosis--a condition of arteries characterized by deposits of fat, cholesterol and other substances--a stroke may result.

The carotids are important and very easy to examine with ultrasound, Tell says. "We know that what we find in the carotids is a reflection of what's happening elsewhere in the body." "The difference in internal carotid wall thickness between current smokers and nonsmokers was greater than the difference associated with 10 years of age among never- smoking participants," the scientists wrote in their report. Until now there have been some doubts as to whether smoking is harmful in older people, Tell says. "But we found smoking has bad effects even among the elderly. People who continue to smoke in old age have more clogged arteries than people who don't." The men and women who participated in this study were selected from Medicare eligibility lists from Allegheny County (Pittsburgh), Pa; Forsyth County, N.C.; Sacramento County, Calif.; and Washington County, Md.

The scientists say there is "abundant evidence" that cigarette smoking causes atherosclerosis. Cigarette smoking is firmly established as a risk factor for coronary heart disease, peripheral vascular disease and stroke, Tell and her associates note. Their study, which is part of the Cardiovascular Health Study, is designed to determine if asymptomatic disease detected with ultrasound progresses less in people who quit smoking.

Source: David Dodell, American Heart Association, August 1995

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