Daily assessment of arterial distensibility in a pediatric population before and after smoking cessation

Abstract

OBJECTIVES:Cigarette smoking is an important modifiable cardiovascular risk factor associated with increased stiffness of the large arteries in adulthood. This study aimed to 1) evaluate arterial distensibility and echocardiographic measures in adolescent smokers before and after participation in a successful smoking cessation program and to 2) compare the findings obtained with data from a control population of healthy non-smokers.METHODS:A total of 31 young smoking subjects (58.1% male; range: 11-18 years old; mean: 16.5±1.4 years old; mean tobacco consumption: 2.6±0.6 years) were examined before commencing and after taking part for at least 1 year in a smoking cessation program (mean: 1.4±0.3 years). Arterial stiffness was measured using the previously validated QKd100-60 method. Twenty-four-hour ambulatory blood pressure monitoring and transthoracic echocardiography were also performed.RESULTS:(Smokers before abuse cessation vs. smokers after abuse cessation) systolic blood pressure: p<0.004; diastolic blood pressure: p<0.02; mean blood pressure: p<0.01; QKd100-60 value: 183±5 vs. 196±3 msec, p<0.009; p = ns for all echocardiographic parameters. (Smokers after abuse cessation vs. controls) systolic blood pressure: p<0.01; diastolic blood pressure: p<0.03; mean blood pressure: p<0.02; QKd100-60 value: 196±3 vs. 203±2 msec, p<0.04; p<0.02, p<0.01, and p<0.05 for the interventricular septum, posterior wall, and left ventricular mass, respectively.CONCLUSIONS:Despite successful participation in a smoking cessation program, arterial distensibility improved but did not normalize. This finding underlines the presence of the harmful effect of arterial rigidity in these individuals, despite their having quit smoking and their young ages, thus resulting in the subsequent need for a lengthy follow-up period.

Novel Aspects of Differences in Arterial Stiffness Parameters during Short Abstinent Period in Smokers vs. Non-smokers

“…Interestingly, the comparison with the results of nonsmokers revealed that there was no difference between the values of non-smokers and smokers on the smoking day, but the value of smokers on the non-smoking day was proven to be 9.41 ± 8.10 bpm lower than that of non-smokers. A similarly designed study published in 2014 examining adolescents before and after smoking cessation and negative controls found that although resting heart rate results were in accordance with expectations, the heart rate of smoking subjects was significantly lower than the heart rate of healthy controls [25]. The authors explained this result with the different activity of participants, what is -based on the same orders given to participants -highly unlikely in our study.…”

Hypertension in Children and Adolescents: A Position Statement From a Panel of Multidisciplinary Experts Coordinated by the French Society of Hypertension

“…Exposure to tobacco is a major risk factor for cardiovascular morbidity and prevention should begin during pregnancy (maternal smoking should be discouraged) and continued at all ages with patients being advised not to start smoking and encouraged to quit if necessary. Specific paediatric studies have already demonstrated the deleterious effect of tobacco exposure on vascular parameters as early as during teenage ( 56 ).…”