Cardiovascular disease, or diseases of the blood vessels and heart, includes stroke, heart attack, peripheral vascular disease, and aortic aneurysm. In 1990 in the United States, one fifth of all deaths due to cardiovascular disease were linked to smoking. Specifically, 179,820 deaths from general cardiovascular disease, 134,235 deaths from heart disease, and 23,281 deaths from cerebrovascular disease (stroke) were directly linked to smoking. In addition, researchers have noted a strong dose-response relationship between the duration and extent of smoking and the death rate from heart disease in men under 65. The more one smokes, the more one is likely to develop heart disease. Researchers have also seen a similar trend in women.
Cigarette smoking leads to cardiovascular disease in a number of ways. Smoking damages the inside of the blood vessels, initiating changes that lead to atherosclerosis, a disease characterized by blood vessel blockage. It also causes the coronary arteries (that supply the heart muscle with oxygen) to constrict, increasing vulnerability of the heart to heart attack (when heart muscle dies as a result of lack of oxygen) and cardiac arrest (when the heart stops beating). Smoking also raises the levels of low-density lipoproteins (the so-called "bad" cholesterol) in the blood, and lowers the levels of high-density lipoproteins (the so-called "good" cholesterol), a situation that has been linked to atherosclerosis. Finally, smoking increases the risk of stroke by 1.5 to 3 times the risk for nonsmokers.
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