The influence of smoking status on the parameters of microcirculation in young individuals, in middle-aged patients with arterial hypertension (AH) and coronary artery disease (CAD) has been studied at the Department of Faculty Therapy of the Far-Eastern State Medical University (Khabarovsk) since 2014.
OBJECTIVE
To assess the influence of smoking and smoking cessation on the parameters of vascular permeability and microhemorheology in young, healthy individuals and middle-aged patients with hypertension and coronary artery disease.
MATERIALS AND METHODS
The overall database (n=267, subjects with different smoking status) was analyzed, in which information about the age and assignment of the patient to a particular group was initially hidden. The study included healthy young people (n=80), patients with primary hypertension (n=95), and middle-aged patients with CAD (n=92). In the statistical procedure, only the microcirculation parameters obtained by videobiomicroscopy of the bulbar conjunctiva were considered. Cluster analysis was used to identify natural groupings of observations.
RESULTS
During cluster analysis, all observations were divided into two clusters. Cluster 1 included all young non-smokers (18.8%) and those who stopped smoking (22.7%), the majority of non-smokers (17%) and those who stopped smoking with hypertension (11%). Cluster 2 included patients with coronary artery disease (66.3%) and the majority of smokers with hypertension (16%). In subjects included in cluster 2, the parameters of vascular permeability and microhaemorheology were significantly abnormally changed in comparison with the parameters in subjects included in cluster 1 (p<0.0001).
CONCLUSIONS
1. At a young age, in subjects without chronic diseases, normal endothelial function compensates for the adverse effects of smoking. 2. In patients with unstable coronary heart disease, significant alterations of the parameters of vascular permeability and microhemorheology are due to the age of patients and acute coronary disease; smoking is not a key factor affecting changes in microcirculation. 3. In young and middle-aged patients with grade I and II hypertension, smoking significantly alters the microcirculation, and smoking cessation has a pronounced beneficial effect.
