Relation of smoking with carotid artery wall thickness and stenosis in older adults: The Cardiovascular Health Study

Abstract

Background: Cigarette smoking has been associated with increased risk of atherosclerotic diseases in hospital-based studies and in studies of middle- aged populations but not in population-based studies of older adults with and without clinical cardiovascular disease. Methods and Results: We investigated the relation of smoking to carotid artery atherosclerotic disease, expressed as intimal-medial wall thickness and arterial lumen narrowing (stenosis) measured by ultrasound. Subjects were 5116 older adults participating in the baseline examination of the Cardiovascular Health Study, a community-based study of cardiovascular diseases in older age. With increased smoking there was significantly greater internal and common carotid wall thickening and internal carotid stenosis: current smokers>former smokers>never-smokers; for instance, the unadjusted percent stenosis was 24%, 20%, and 16%, respectively (P