Second-hand cigarette smoke damages healthy hearts

The acute effects of second-hand cigarette smoke (also known as "passive smoking") on coronary artery circulation was determined (using coronary flow velocity reserve [CVFR], assessed by Doppler echocardiography) in 30 males (mean age, 27 years; 15 healthy nonsmokers and 15 asymptomatic smokers). Mean CVFR in nonsmokers was significantly higher than that in smokers before exposure to second-hand smoke. After exposure, CVFR decreased significantly in nonsmokers to a level that was similar to that of smokers. The authors concluded that exposure of healthy nonsmokers to second-hand smoke may cause acute endothelial dysfunction of the coronary circulation, which is considered to be an early stage in the development of atherosclerosis.

Comment: Epidemiological studies have shown that exposure to second-hand smoke is a risk factor for ischemic heart disease and may be associated with vascular endothelial dysfunction. While such associations do not prove causation, the present study provides direct evidence that second-hand smoke can, indeed, cause cardiovascular problems. An editorial accompanying this article (JAMA 2001;286:462-3) suggested that "everyone should be protected from even short-term exposure to the toxins in second-hand smoke." Aside from the obvious importance of promoting smoke-free workplaces, restaurants, and other public meeting places, the idea that second-hand smoke is always dangerous has great potential for new areas of legal action in this litigious society. So, smokers, be careful where you blow your smoke, lest you be hit with a personal-injury suit, not to mention charges of assault and battery.

Otsuka R, e al. Acute effects of passive smoking on the coronary circulation in healthy young adults. JAMA 2001;286:436-441.

COPYRIGHT 2001 The Townsend Letter Group
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