Imagine two patients show up at the hospital with a heart attack- patient A is 10 years younger than patient B; but despite of the age difference, patient A’s coronary artery disease is likely to be as advanced as that of patient B. Why? Because patient A was a smoker!
This has been evidenced by a new clinical study published in the Journal JACC: Cardiovascular Interventions. Researchers looked at nearly 14,000 patients hospitalized with blockages in arteries supplying the heart muscle and found smokers were more likely than non smokers to die within a year.
Despite their being younger, and otherwise healthier, the smokers' heart arteries were in a condition similar to those of non smokers 10 years older.
"We saw smokers presenting the disease at age 55 and non smokers presenting the same disease at 65," said Dr. Alexandra Lansky, a researcher on the study.
Why Does it Happen?
When a person smokes, their blood clots, which gets stuck in the narrow arteres which are very rigid and have already been clogged by cholesterol and fat buildup.
This condition of fat buildup and stiffening of artery walls is known as atherosclerosis. With age, it becomes morepotential for everyone; but the clots caused by smoking worsen the clockages.
That makes smokers more likely to have a heart attack at a younger age, but less likely to have the other conditions, known as comorbidities, that go along with aging, such as diabetes and high blood pressure.
What Does it Mean?
"Smoking accelerates the manifestation of coronary disease but in the absence of these comorbidities," Lansky told Reuters Health.
Past research has identified a "smoker's paradox" - because smokers are younger, with fewer other health problems, when they had a heart attack, they were more likely to recover it. Or so it seemed.
"We wanted to look at longer-term effects of smoking rather just the short term effect," Lansky said.
What is the Bottom Line?
"What makes it novel, is that we are showing that if you come in, your chance of survival is already reduced, as a smoker," Lansky said.
The findings are not surprising, according to Dr. Robert Giugliano, a cardiologist at Brigham and Women's Hospital in Boston.
"Nonetheless, the public does need to know that there is now even more evidence that smoking is bad for your health, accelerates the process of atherosclerosis (so smokers have heart and vascular disease on average 10 years early than non-smokers), and leads to worse outcomes compared to non-smokers of a similar age," said Giugliano, who also teaches at Harvard Medical School.
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