Tobacco Smoking and Atherosclerosis: Overview

Abstract

Epidemiological studies from a variety of countries throughout the world have clearly established a relationship between smoking cigarettes and the development and/or progression of the atherosclerotic process (1). Although the epidemiologic evidence which correlates smoking and atherosclerosis is extensive, and thereby convincing, from a rigorous scientific point of view there are confounding variables in such studies which need further clarification. These confounding variables are life-style factors which predispose the individual to atherosclerotic disease in general (and coronary heart disease in particular), and are typified by sedentary living habits; obesity and/or unrestrained weight gain; a dietary intake which contains an excessive number of calories, fat, saturated fat, cholesterol, and salt; personal stress that is not modified; as well as cigarette smoking. It is not clear just how all of these risk factors interrelate among or between each other as variables in the pathogenesis of atherosclerosis. Analytical models which can unambiguously discriminate between such risk factors for a weighting of their contribution to the overall atherosclerotic process have yet to be developed.