Association Between Secondhand Tobacco Smoke Exposure and Atherosclerosis

There may be a greater association between the extent of secondhand tobacco smoke exposure and the extent of atherosclerosis than previously thought, according to the results of research presented Nov. 13 during AHA 2016 and simultaneously published in JACC: Cardiovascular Imaging.

David F. Yankelevitz, MD, et al., analyzed the responses from questionnaires of 268 never-smokers between the ages of 40 – 80 on their exposure to secondhand tobacco smoke during their lifetime. Researchers used low-dose nongated computed tomographic (CT) scans, followed by CT angiography, to derive ordinal coronary artery calcium scores, which were then evaluated for characteristics of atherosclerosis.

The results of the study show that coronary atherosclerosis was noted in 48 percent of patients and was more frequent with low to moderate and high vs. minimal secondhand tobacco smoke exposure (48 percent and 69 percent vs. 25 percent). Further, as the reported exposure to secondhand tobacco smoke increased, the percentage of major vessel with any plaque or stenosis increased.

The authors conclude that "the presence and extent of atherosclerosis were associated with the extent of secondhand tobacco smoke exposure even when adjusted for other risk factors, further demonstrating the causal relationship of secondhand tobacco smoke exposure and coronary disease."

In an accompanying editorial comment, Khurram Nasir, MD, MPH, FACC, and Jaideep Patel, MD, note that "although the study sample size is modest, the initial insights are astounding." They add that the study provides an opportunity to caution the public against the effects of secondhand smoke and to encourage policymakers to further advance efforts to implement smoke-free laws, especially in public spaces.

Clinical Topics: Prevention

Keywords: AHA16, American Heart Association, AHA Annual Scientific Sessions, Secondary Prevention

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