Diseases Ofthe Heart And Blood Vessels

Coronary heart disease (CHD) is now the leading cause of death in many developed countries. In the UK about 30% of these deaths can be attributed to smoking.

Under the age of 65 years smokers are about twice as likely to die of ischaemic heart disease as are nonsmokers, and heavy smokers about 3.5 times as likely.

Sudden death may be the first manifestation of CHD and, especially in young men, is related to cigarette smoking. Smoking is especially dangerous for people in whom other risk factors (increased blood cholesterol, high blood pressure) are present.

16 Peto R et al 2000 Smoking, smoking cessation, and lung cancer in the UK since 1950: combination of national statistics with two case-control studies. British Medical Journal 321: 323-329.

Atherosclerotic narrowing of the smallest coronary arteries is enormously increased in heavy and even in moderate smokers; the increased platelet adhesiveness caused by smoking increases the readiness with which thrombi form.

Stopping smoking reduces the excess risk of CHD in people under the age of 65, and after about 4 years of abstinence the risk approximates to that of nonsmokers.

Pipe and cigar smokers run little or no excess risk of CHD provided they are not heavy smokers and do not inhale. Heavy cigarette smokers who change over to pipe or cigar smoking often continue to inhale and thereby fail to reduce their risk.

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