Circulation. 2005;111:2684-2698
doi: 10.1161/CIRCULATIONAHA.104.492215
doi: 10.1161/CIRCULATIONAHA.104.492215
(Circulation. 2005;111:2684-2698.)
© 2005 American Heart Association, Inc.
Special Report |
Cardiovascular Effects of Secondhand Smoke
Nearly as Large as Smoking
From the Center for Tobacco Control Research and Education, Cardiovascular Research Institute, and Division of Cardiology, University of California, San Francisco.
Reprint requests to Stanton A. Glantz, PhD, Professor of Medicine, University of California, San Francisco, 530 Parnassus, Suite 366, San Francisco, CA 94143-1390. E-mail glantz{at}medicine.ucsf.edu
Background— Secondhand smoke increases the risk of coronary heart disease by 
30%. This effect is larger than one would expect on the basis of the risks associated with active smoking and the relative doses of tobacco smoke delivered to smokers and nonsmokers.
Methods and Results— We conducted a literature review of the research describing the mechanistic effects of secondhand smoke on the cardiovascular system, emphasizing research published since 1995, and compared the effects of secondhand smoke with the effects of active smoking. Evidence is rapidly accumulating that the cardiovascular system—platelet and endothelial function, arterial stiffness, atherosclerosis, oxidative stress, inflammation, heart rate variability, energy metabolism, and increased infarct size—is exquisitely sensitive to the toxins in secondhand smoke. The effects of even brief (minutes to hours) passive smoking are often nearly as large (averaging 80% to 90%) as chronic active smoking.
Conclusions— The effects of secondhand smoke are substantial and rapid, explaining the relatively large risks that have been reported in epidemiological studies.
Key Words: smoking • cardiovascular diseases • endothelium • epidemiology • tobacco smoke pollution
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