MUNICH – Smoking in young people can induce structural changes to the arterial wall and possibly lead to the development of atherosclerosis before adulthood, according to a Swiss study.
Ultrasound analysis of the common carotid artery of adolescents who actively smoked showed that their intima-media was as much as 0.03 mm thicker than those of youth who didn’t smoke, researchers reported at the annual congress of the European Society of Cardiology.
While the preliminary findings may not dissuade adolescents from smoking, they highlight the need for prevention efforts, such as implementing smoking bans in cities and states, said study investigator Dr. Julia Dratva, a research fellow at the Swiss Tropical and Public Health Institute, Basel.
Studies have established the negative health effects of tobacco exposure in adolescents, but the Swiss study is one of the first to show the impact of smoking on the arterial walls of youths.
"What the study does is make it clear that the vascular wall starts falling into pieces," in youth who smoke, session moderator Dr. Joep Perk said in an interview. "So you are starting on a path that your vascular wall is going to be eventually plugged," added Dr. Perk, professor of health sciences at Linnaeus University, Sweden.
Researchers recruited 279 subjects in the Swiss Study on Air Pollution and Lung and Heart Disease in Adults (SAPALDIA) Youth Study. Study participants were between ages 9 and 20. Their clinical examination included anthropometry, blood pressure measurement, ultrasound assessment of the carotid artery intima-media thickness, and blood tests for cardiovascular biomarkers.
Many of the study participants had cardiovascular disease risk factors that are known to continue into adulthood and are associated with increased atherosclerotic risk, the authors reported. Thirteen percent of the youth were overweight, 3% had elevated cholesterol, 5% had an HbA1c level higher than 5.7%, and blood pressure was elevated in 7%.
Ten percent of the participants reported weekly smoking (at least one cigarette per week), and 14% reported smoking monthly. Very few reported daily smoking habits, said Dr. Dratva. Mean smoking duration was 2.3 years in ever-smokers. Exposure to passive smoke up to 10 years of age was reported by 31% and current parental smoking by 25%.
Results showed that smoking duration was positively associated with common carotid intima-media thickness (0.014-mm increase/year). The carotid intima-media was significantly thicker in youth who smoked weekly (0.03 mm) compared with those who didn’t smoke. The results remained consistent after adjustment for parental smoking.
Meanwhile, there was not a significant difference in the intima-media thickness among those who reported smoking at least once a month and those who said they didn’t smoke (slightly more than a 0.01-mm difference).
"The thickening of the intima-media is reversible," said Dr. Dratva. "But we don’t know for how long this reversibility will stay," and there’s a need for further investigations, she said.
Dr. Dratva reported no financial conflicts.