Current and Controversial Features of Cardiovascular Damage from Cigarette Smoking

A great number of studies have undoubtedly demonstrated that cardiovascular damage from cigarette smoking cannot be denied, although some controversies on the topic still exist. The damage to the heart and blood vessels is initially characterized by transient functional alterations consisting of endothelial dysfunction, reduced exercise tolerance, increased systolic blood pressure and heart rate following acute exposure. On the contrary, chronic exposure to smoking develops, at the time, firstly reversible and, then, irreversible lesions mainly involving myocardium with an ischemic damage and smoke cardiomyopathy as well as coronary, carotid and cerebral arteries, which display atherosclerotic pathology. The analysis of the epidemiological studies on cardiovascular damage support the controversies on the effects of smoking, because not the same alterations are sometimes observed in different studies on the topic. However, when standardized experimental procedures are followed, the same alterations are clearly reproduced showing that cardiovascular damage from cigarette smoking cannot be denied.