Active and passive smoking, XXXX , and the risk of @entity2998 : prospective results from the Bruneck Study.

@entity286 @entity2998 @entity281 @entity1856 @entity731 @entity166
BACKGROUND AND PURPOSE: Susceptibility of the vasculature to the injurious effects of smoking varies substantially, with some smokers developing severe @entity731 and others remaining free of advanced @entity1856 until high ages. The present study sought to estimate the contribution of @entity281 to the variability of @entity731 severity among smokers. METHODS: In the community-based Bruneck Study, 5-year changes in @entity2998 were assessed by high-resolution ultrasound. Early @entity731 was defined by the development of nonstenotic plaques and advanced @entity731 by the development/progression of vessel stenosis >40%. RESULTS: The risk of early @entity731 strongly relied on lifetime smoking exposure and remained elevated long-term after cessation of smoking. Remarkably, current and ex-smokers faced an increased @entity731 risk only in the presence of @entity281 (odds ratios [95% CIs], 3.3 [1.8 to 6.2] and 3.4 [1.8 to 6.3]; P<0.001 each), whereas current, past, and nonsmokers without infections did not differ substantially in their estimated risk burden (odds ratios [95% CIs], 1.4 [0.8 to 2.4], 0.9 [0.6 to 1.6], and 1.0 [reference group]). In analogy to first-hand smoking, subjects exposed to environmental @entity286 smoke were found to be vulnerable to the manifestation of @entity281 , and only those infected experienced a high @entity731 risk. The risk of advanced @entity731 showed a dose-response relation with the number of daily cigarettes, returned to normal shortly after cessation of smoking, and emerged as independent of @entity166 . CONCLUSIONS: Our study provides the first epidemiological evidence that the proatherogenic effects of cigarette smoking are mediated in part by the @entity281 found in smokers. A better understanding of the vascular pathogenetic mechanisms of smoking may offer novel clues for disease prevention supplementary to the primary goal of achieving long-term abstinence.
