Study On The Relationship Between Male Smoking Status And Vascular Structure And Function

Objective: This study aims to explore the relationship between different smoking statuses in males and atherosclerosis and arterial stiffness at the population level,providing a scientific basis for promoting smoking cessation and preventing cardiovascular diseases.Methods: A cluster sampling method was used to invite male residents aged 18 years or older from a community in Dali City to participate in the study from September to November 2018.After excluding subjects with incomplete information or unable to complete the pulse wave velocity(PWV)test,248 participants were included for statistical analysis.A questionnaire was used to collect information on drinking,smoking status,medical history,and medication use.Fasting venous blood was collected to measure biochemical indicators such as total cholesterol and blood glucose.A mercury sphygmomanometer was used to measure blood pressure at the peripheral(brachial artery)5 times,and the mean value was taken for statistical analysis.The diagnostic criteria for hypertension were as follows: brachial systolic blood pressure≥140mm Hg and/or diastolic blood pressure ≥90mm Hg,or a history of hypertension with current antihypertensive treatment.An arterial stiffness detector(VP-2000)was used to measure the brachial-ankle pulse wave velocity(ba PWV)and ankle-brachial index(ABI).A cardiovascular function detection instrument(Sphygmo Cor XCEL)was used to measure central arterial pressure and carotid-femoral pulse wave velocity(cf PWV).Arteriosclerosis was diagnosed using two definitions: cf PWV >11m/s and ba PWV >1800cm/s,respectively.Carotid artery thickening was defined as an intimamedia thickness(IMT)of ≥1mm,while carotid atherosclerosis was defined as the presence of at least one plaque in the carotid artery.Peripheral arterial disease was defined as an ABI ≤0.9.Based on self-reported smoking status,participants were divided into three groups: never,current,and former smokers.Data management and statistical analysis were performed using SAS 9.4 and Empower software.Results:1.Of the 248 male participants,75 were never smokers,38 were former smokers(15.3%),and 135(54.4%)were current smokers.The former smoker group had a relatively older age and significantly increased intima-media thickness of the carotid artery,but there were no statistically significant differences in body mass index,fasting blood glucose,total cholesterol,ba PWV,cf PWV,ABI,central arterial augmentation pressure,central arterial reflection wave augmentation index,peripheral blood pressure,central blood pressure,heart rate,diabetes prevalence,and hypertension prevalence among the three groups.2.Before adjusting for covariates,compared with the never-smoker group,the former-smoker group had significantly higher central arterial augmentation pressure(β=2.43,95%CI 0.15-4.71,P=0.0375),central arterial reflection wave augmentation index(β=4.78,95%CI 0.15-9.41,P=0.0441),and intima-media thickness of the carotid artery(β=0.13,95%CI 0.05-0.22,P=0.0030),while the ABI of current smokers was lower than that of never smokers(β=-0.03,95%CI-0.06-0.00,P=0.0530).After adjusting for covariates such as age,body mass index,fasting blood glucose,total cholesterol,hypertension,diabetes,and alcohol consumption,only the ABI of current smokers(β=-0.03,95%CI-0.06--0.00,P=0.0384)showed a significant decrease compared with the never smoker group,and other relationships became insignificant.3.Logistic regression analysis found that before adjusting for covariates,compared with never-smokers,former smokers had a significantly increased risk of carotid artery atherosclerosis(OR=3.64,95%CI 1.59-8.33,P=0.0023).However,after adjusting for covariates such as age,body mass index,fasting blood glucose,total cholesterol,hypertension,diabetes,and alcohol consumption,the risk of carotid artery atherosclerosis in former smokers became marginally correlated(OR=2.84,95%CI 1.00-8.08,P=0.0507),while the risk of ba PWV > 1800cm/s in former smokers was significantly reduced by 87%(OR=0.13,95%CI 0.02-0.78,P=0.0263).4.In current smokers,linear regression analysis found that before adjusting for covariates,smoking duration was positively associated with ba PWV,cf PWV,central arterial augmentation pressure,central arterial reflection wave augmentation index,central pulse pressure,and intima-media thickness of the carotid artery(P≤0.0263).However,after adjusting for covariates such as age,body mass index,fasting blood glucose,total cholesterol,hypertension,diabetes,and alcohol consumption,these relationships became insignificant(P≥0.1694).5.In current smokers,multiple linear regression analysis found that after adjusting for covariates such as age,body mass index,fasting blood glucose,total cholesterol,hypertension,diabetes,and alcohol consumption,the current smoking amount was not significantly associated with indicators of arterial sclerosis.6.High-sensitivity C-reactive protein was not significantly associated with smoking status.Conclusions: In this small cross-sectional study,more than half of the male population were current smokers,and current smoking was independently associated with a decreased ankle-brachial index and a potentially increased risk of peripheral artery disease;former smokers still had a higher risk of carotid artery atherosclerosis.Due to the influence of sample size,passive smoking,and other confounding factors,this study did not confirm the impact of current smoking on arterial stiffness and atherosclerosis.Future large-scale prospective population studies and intervention trials in the region are needed to clarify the magnitude of the effects of smoking on vascular structure and function,as well as the degree of reversal of vascular damage after smoking cessation.