Smoking or High Blood Pressure, Which one is more Important in Premature Coronary ArteryDisease?

BACKGROUND:
Cigarette smoking and hypertension (HTN), are both major risk factors for premature atherosclerosis. Currently, limited information is available from the effect of these risk factors on the Pattern of vessel involvement and also on the left ventricular ejection fraction (LVEF) at coronary angiography. Our study compared their effects on angiography of patients with premature atherosclerosis.

METHODS:
The study included 240 consecutive patients, under age of 45 years old, cigarette smoker or hypertensive hospitalized with a diagnosis of acute coronary syndrome. These patients underwent coronary angiography. Number and type of vessel involvement and also LVEF were studied. Logistic regression was used for data analysis.

FINDINGS:
Of patients, 24 were both smoker and hypertensive, and were excluded from this study. In addition, 142 of 216 patients (65.7%) were smoker and 74 (33.4%) were hypertensive. Left anterior descending coronary artery (LAD) involvement was more common in smoker young patient and low LVEF was more common in these patients compared with hypertensive young patients (28.2% versus 17.6%, respectively).

CONCLUSION:
Our findings indicate that smoking is more prevalent risk factor for premature coronary artery disease. Smoking has a significant effect on the pattern of vessel involvement and LVEF at coronary angiography of young patients. Our study emphasized on the importance of modifying in young active population.

KEY WORDS:
Smoking, hypertension, premature coronary artery disease.