To the content
2 . 2022

Smoking status and its relationship with early vascular aging


Background. Smoking status is associated with structural and functional vascular changes which may lead to increased arterial stiffness and, as a consequence, the formation of early vascular aging.

The aim of this study was to investigate the relationship between the modifiable risk factors and early vascular aging (EVA-syndrome).

Material and methods. The material of the study was the data of a survey of 783 men aged 20 to 92 years (mean age 48.2±10.32 years) undergoing medical examination in the group of SOGAZ Medical Center clinics. To assess the vascular age, the AngioScan‑01 photoplethysmography method was used. The following indicators were evaluated: stiffness index (SI), reflection index (RI), augmentation index (Alp75), age index (AGI) and pulse wave types (PV-type). To determine the vascular age (VA), a correlation field of the dependence of the actual (passport) age on the age index (AGI) was built, and then the age of the vascular system was calculated from the value of the age index. The criteria for early vascular aging syndrome (EVA-syndrome) were considered AGI values beyond the 90th percentile.

Results. The greatest correlation with passport age was revealed for the “age index” indicator (r=0.54) at the first stage of the study. EVA-syndrome criteria were considered as values of the AGI, beyond the 90th percentile (n=65), and the criteria for “young vascular age” (n=87) were AGI values below 10 percentile with age correction. Comparison of these two alternative subgroups (in men aged from 40 to 59) in terms of arterial stiffness showed significant differences in terms of SI, Alp75, PV-type. The frequency of detection of multiple risk factors according to the results of questionnaires and laboratory diagnostics was also significantly higher. Assessment of the contribution of vascular risk factors to vascular aging showed that the leading positions are occupied by hypertension (OR=4.4; p<0.05), hyperglycemia (OR=3.2; p<0.05), hypertriglyceridemia (OR=2.9; p<0.05) and smoking (OR=2.23; p<0.05).

Smoking status should be considered as the most aggressive of all behavioral risk factors. Its contribution to early vascular aging was significantly greater than risk factors such as abdominal obesity, physical inactivity, stressful work patterns, unrestricted diet and alcohol abuse. The values of arterial stiffness in age-comparable individuals depending on smoking status revealed a significant decrease in arterial compliance and an increase in arterial stiffness according to PPG data. Long-term (>20 years) smoking experience was associated with 11.6 potentially lost years of life.

Conclusion. The data obtained support the importance of developing an algorithm for the actions of a therapist and a cardiologist in the fight against smoking as a key behavioral risk factor for the development of ASCVD and a reduction in life expectancy.

Keywords:arterial stiffness; vascular age; smoking; early vascular aging

Funding. The study had no sponsor support.

Conflict of interest. This publication was supported by the PMI Science project. PMI Science was not involved in data collection, analysis, interpretation, or the decision to publish study results. The opinions expressed in this publication are those of the authors.

For citation: Filippov A.E., Lazurenko E.V., Tuktarov A.M. Smoking status and its relationship with early vascular aging. Kardiologiya: novosti, mneniya, obuchenie [Cardiology: News, Opinions, Training]. 2022; 10 (2): 38–44. DOI: (in Russian)


1. Rehill N., Beck C.R., Yeo K.R., Yeo W.W. The effect of chronic tobacco smoking on arterial stiffness. Br J Clin Pharmacol. 2006; 61 (6): 767–73.

2. Ambrose J.A., Barua R.S. The pathophysiology of cigarette smoking and cardiovascular disease: an update. J Am Coll Cardiol. 2004; 43: 1731–7.

3. Wei Y.J., Liu H.L., Liu B., Lu Z., Zhi-Genget J. Impact of smoking and smoking cessation on arterial stiffness in healthy participants. Angiology. 2013; 64: 273–80.

4. Ben-Shlomo Y., Spears M., Boustred C., May M., Anderson S.G., Benjamin E.J., Boutouyrie P., Cameron J., Chen C.-H., Cruickshank J.K., Hwang S.-J., Lakatta E.G., Laurent S., Maldonado J., Mitchell G.F., Najjar S.S., Newman A.B., Ohishi M., Pannier B., Pereira T., Vasan R., Shokawa T., Sutton-Tyrell K., Verbeke F., Wang K.-L., Webb D.J., Hansen T.W., Zoungas S., McEniery C.M., Cockcroft J.R., Wilkinson I.B. Aortic pulse wave velocity improves cardiovascular event prediction: an individual participant meta-analysis of prospective observational data from 17,635 subjects. J Am Coll Cardiol. 2014; 63 (7): 636–46.

5. Nilsson P.M. A Tale of EVA and ADAM in cardiovascular risk assessment and prevention. Hypertension. 2009; 54: 3–10.

6. Tesauro M., Mauriello A., Rovella V., Annicchiarico-Petruzzelli M., Cardillo C., Melino G., Di Daniele N. Arterial ageing: from endothelial dysfunction to vascular calcification. J Intern Med. 2017; 281 (5): 471–82.

7. Cunha P.G., Cotter J., Oliveira P., Vila I., Boutouyrie P., Laurent S., Nilsson P.M., Scuteri A., Sousaet N. Pulse wave velocity distribution in a cohort study: from arterial stiffness to early vascular aging. J Hypertens. 2015; 33 (7): 1438–45.

8. Sehgel N.L., Sun Z., Hong Z., Hunter W.C., Hill M.A., Vatner D.E., Vatner S.F., Meininger G.A. Augmented vascular smooth muscle cell stiffness and adhesion when hypertension is superimposed on aging. Hypertension. 2015; 65 (2): 370–7.

9. Doonan R., Hausvater A., Scallan C., Mikhailidis D.P., Pilote L., Daskalopoulouet S.S. The effect of smoking on arterial stiffness. Hypertens Res. 2010; 33; 398–410.

10. Mahmud A., Feely J. Effect of smoking on arterial stiffness and pulse pressure amplification. Hypertension. 2003; 41: 183–7.

11. Node K., Kitakaze M., Yoshikawa H., Kosaka H., Horiet M. Reversible reduction in plasma concentration of nitric oxide induced by cigarette smoking in young adults. Am J Cardiol. 1997; 79: 1538–41.

12. Lee G.B., Shim J.S., Kim H.C. Dose-response association between smoking cessation and arterial stiffness: the cardiovascular and metabolic diseases etiology research center (CMERC) cohort. Korean Circ J. 2020; 50 (4): 361–9.

13. Middlekauff H.R., Park J., Moheimani R.S. Adverse effects of cigarette and noncigarette smoke exposure on the autonomic nervous system: mechanisms and implications for cardiovascular risk. J Am Coll Cardiol. 2014; 64: 1740–50.

14. Oren S., Isakov I., Golzman B., Kogan J., Turkot S., Peled R., Yosefyet C. The influence of smoking cessation on hemodynamics and arterial compliance. Angiology. 2006; 57: 564–8.

15. Barua R.S., Ambrose J.A. Mechanisms of coronary thrombosis in cigarette smoke exposure. Arteriosclerosis, Thrombosis, and Vascular Biology. 2013; 33: 1460–7.

16. Ikonomidis I., Vlastos D., Kostelli G., Kourea K., Katogiannis K., Tsoumani M., Parissis J., Andreadou I., Alexopoulos D. Differential effects of heat-not-burn and conventional cigarettes on coronary flow, myocardial and vascular function. Sci Rep. 2021; 11: 11808.

Andrey G. Obrezan
MD, Professor, Head of the Hospital Therapy Department of the Saint Petersburg State University, Chief Physician of SOGAZ MEDICINE Clinical Group, St. Petersburg, Russian Federation
Medicine today

II Всероссийская конференция с международным участием "Воспаление глаза" 12 ноября 2022 года, Москва Воспалительные заболевания глаза - широко распространенная и многогранная проблема, с которой может столкнуться в своей практике любой специалист. Найти оптимальные алгоритмы...

Масштабное событие в области дерматовенерологии и косметологии - II конференция InteDeCo 2022 "Интегративная дерматовенерология и косметология. Новые стандарты взаимодействия" - состоится 16-17 декабря 2022 года. Программа мероприятия пройдет на современной...

VIII Московский Городской Съезд педиатров с межрегиональным и международным участием "Трудный диагноз в педиатрии" Приглашаем педиатров, детских эндокринологов, реаниматологов, гинекологов, неонатологов, кардиологов, хирургов, урологов, психологов, специалистов по лучевой...

Journals of «GEOTAR-Media»