In a new study, researchers found that cigarette smoking boosts the risk of peripheral artery disease, and this elevated risk can persist up to 30 years after smoking cessation.
They also found that the link between smoking and peripheral artery disease was even stronger than that for coronary heart disease and stroke.
The research was led by the Johns Hopkins Bloomberg School of Public Health.
Peripheral artery disease features the atherosclerotic buildup of cholesterol-laden deposits in arteries serving the legs.
The reduction of blood flow leads to limb pain, poor wound healing, and other signs and symptoms.
The U.S. Centers for Disease Control and Prevention estimates that about 8.5 million people in the U.S. have peripheral artery disease.
This includes more than 10% of people older than 69, though most cases go undiagnosed and there is relatively little public awareness of the disorder.
In the new study, the team analyzed a sample of 13,355 participants, including 3,323 current smokers and 4,185 former smokers, who were tracked for a median period of 26 years.
They found that compared with never-smokers, those who smoked for more than 40 pack-years had roughly 4 times more risk for peripheral artery disease.
These smokers also had 2.1 times and 1.8 times more risk for coronary heart disease and stroke, respectively.
Similarly, participants who reported currently smoking more than a pack per day had a relative increased risk—5.4 times more for peripheral artery disease versus 2.4 for coronary heart disease and 1.9 for stroke—compared to those who had never smoked.
The team also found the effect of smoking on peripheral artery disease risk was not just stronger; it was also longer-lasting.
Only after 30 years of smoking cessation did the peripheral artery disease risk for former smokers return to the baseline level seen in never-smokers.
By comparison, coronary heart disease risk took about 20 years to return to baseline after smoking cessation.
The findings underscore the importance of both smoking prevention for nonsmokers and early smoking cessation for smokers.
The team suggests that campaigns about smoking’s health risks should emphasize the elevated risk of peripheral artery disease, not just coronary heart disease, and stroke.
This is the first comprehensive comparison of the smoking-elevated risks of peripheral artery disease, coronary heart disease and stroke in a large population moving through time.
One author of the study is Kunihiro Matsushita, MD, Ph.D., associate professor in the Department of Epidemiology at the Bloomberg School.
The study is published in the Journal of the American College of Cardiology.
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