Smoking: A High Risk Factor of Atherosclerosis and its Serious Consequences

Cigarette smoking is a major modifiable risk factor for cardiovascular disease (CVD), including coronary artery disease (CAD), heart attacks, stroke, peripheral vascular disease, and congestive heart failure. The hazardous effects of smoking on the cardiovascular system are multiple and synergistic. Mechanisms include mainly vascular endothelial and smooth cell dysfunction, enhanced platelet aggregability, disturbed lipid profile, thrombosis, and hemodynamic changes. These effects, both, increase the likelihood of an acute event as well as contribute to longterm development of CAD. Tobacco smoke may also cause insulin resistance, a risk factor for diabetes and CVD. The same mechanisms responsible for CVD in active smokers are nearly as large in passive smokers. The specific ingredients of cigarette smoke responsible for its cardiovascular effects include mainly the polycyclic aromatic hydrocarbons, nicotine, oxidizing agents and particulate matter. Although smoking has been well clarified as the leading cause of cardiovascular morbidity and mortality worldwide, still a large scale of population continues to smoke while others start to smoke adding more victims to this bad habit. The death toll from tobacco is expected to climb to about 10 million people per year within next 25 years. 70% of victims will be in lowand middleincome countries. It is estimated that eventually 50% of all smokers will be killed by direct or indirect effects of tobacco. This review highlights atherosclerosis as one of the serious complications of smoking with discussion of its mechanisms and detrimental consequences particularly peripheral arterial disease, stroke and coronary artery