Smoking can weaken central artery


POSTED: Thursday, November 20, 2008

The Great American Smokeout is being observed in Hawaii today with researchers reporting another big reason for kicking the smoking habit or not starting it.

Data from the Women's Health Initiative found women who smoke are eight times more likely than nonsmokers to suffer a potentially fatal rupture of the body's largest artery, said Hawaii investigator David Curb.

Or they could need surgery to repair weakening of the aorta, the main artery carrying blood from the heart.

The Women's Health Initiative is a nationwide study of 160,000 post-menopausal women, including 3,200 in Hawaii.

Most Asian and Pacific Islander participants are from here, said Curb, University of Hawaii professor and Pacific Health Research Institute researcher. “;We were able to provide data on that group of women in a way a lot of other centers weren't able to.”;

Dr. Frank Lederle, internist at the Veterans Administration Medical Center in Minneapolis and a University of Minnesota professor, led the analysis resulting in new findings on abdominal aortic aneurysm in women.

An aneurysm occurs when an area in the aorta's wall is weakened and begins ballooning. It can rupture, causing a person to bleed to death within seconds or hours. About 15,000 Americans die annually from a ruptured aorta—40 percent of them women, the researchers said.

“;It's one of those things people thought was important in men but not so important in women,”; Curb said.

Abdominal aortic aneurysms are more common in men but more deadly in women, the study showed. Fewer women than men survive surgery to repair a weakened artery.

Discussing the study in Washingtonpost.com and Canadian Press reports, Lederle said the smoking-aneurysm relationship was expected and it is strong. Even women who quit smoking had a fourfold higher incidence of rupture than women who never smoked, he said.

“;Smoking is much more potent a factor in aortic aneurysm than it is in coronary artery disease or cerebral vascular disease—many times more,”; Lederle said.

There are no symptoms until an aneurysm begins to rupture, which can be 10 years after it starts to form, he said.

An interesting finding in the study was that women with diabetes were less likely to have a rupture or surgery, possibly because diabetes makes the arteries stiff, Lederle said.

Curb said this has to be investigated further: “;It's not clear why that would occur.”;

Diabetes is usually a disease of small vessels, not large vessels like the aorta, he said.

The study, published online Oct. 15 in the British Medical Journal, found hormone replacement therapy reduced the risk of abdominal aortic aneurysm, but Lederle said his team is not recommending it for that purpose.

Many women abandoned hormone replacement therapy after the landmark Women's Health Initiative reported in 2002 that it increases the risk of heart problems.

Women are advised to be screened, especially if they smoke, have high blood pressure, a family history of the condition or are older, because an aneurysm grows slowly.

The researchers have followed women in the study for more than 10 years and are continuing to monitor their health issues, Curb said.

“;It's a very valuable group of women,”; he said, pointing out it is the first large study ever done on women's health over time.