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07 June 2011

Smokers show higher risk of peripheral artery disease

Women who smoke are much more likely than non-smokers to develop peripheral arterial disease (PAD), but quitting can lower those odds, according to a study published.

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Women who smoke are much more likely than non-smokers to develop peripheral arterial disease (PAD), but quitting can lower those odds, according to a study published.

The study, reported in the Annals of Internal Medicine found that female smokers were up to 17 times more likely than non-smokers to develop PAD.

"Our most important finding, in my view, is that smoking cessation substantially reduces this risk," said lead researcher Dr David Conen, of the University Hospital Basel in Switzerland.

"We found a gradual decrease in risk with an increased duration of smoking abstinence, highlighting the importance of smoking cessation," Dr Conen said.

Three times the risk

Compared with lifelong non-smokers, former smokers had three times the risk of developing PAD over 13 years.

But current smokers showed much higher odds: those who smoked fewer than 15 cigarettes a day had a nine-fold higher risk of PAD than lifelong non-smokers, while those who lit up more often had a 17-times higher risk.

"Clearly, our study adds one more reason to quit smoking as soon as possible," Dr Conen said.

However, he added, "the fact that the risk of PAD does not get down to that of women who never smoked also emphasises the importance that never starting smoking is at least as important."

The findings

The findings come from a long-running study of US women who were age 45 or older and free of heart disease and other major health problems at the outset. Of nearly 40,000 women followed for 13 years, 178 were eventually diagnosed with PAD.

Among the heaviest smokers - 15 or more cigarettes per day - PAD was diagnosed at a rate of 1.6 cases for every 1,000 women each year. Among lifelong non-smokers, there were 0.1 cases for every 1,000 women each year.

When Dr Conen's team accounted for other PAD risk factors, like older age, obesity and diabetes, smoking itself was still strongly linked to the disease.

The researchers also gained some clues as to why smoking might lead to PAD. Based on blood samples from a subgroup of women, high levels of inflammatory proteins accounted for some of the risk linked to smoking.

That, Dr Conen's team says, suggests that smoking leads to PAD, in part, by spurring chronic inflammation in the blood vessels. He concluded by emphasising the importance of doctors looking for signs and symptoms of PAD in patients who smoke. (Reuters Health/ May 2011)

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