Smoking, Heart Disease, Stroke and Peripheral Artery Disease: How They Are Linked

Heart disease, stroke and peripheral artery disease are cardiovascular diseases (CVDs) — diseases of the heart and blood vessels.

The diseases

Heart disease covers several conditions. The most common in the United States is coronary heart disease (coronary artery disease), in which plaque narrows the arteries that feed the heart — atherosclerosis. It can cause:

• chest pain;
• a heart attack — blood flow to the heart is blocked and part of the heart muscle is damaged or dies;
• heart failure — the heart can't pump enough blood and oxygen for the other organs;
• arrhythmia — the heart beats too fast, too slow or irregularly.

A stroke happens when the blood supply to the brain is blocked, or a blood vessel in the brain bursts, so parts of the brain are damaged or die. It can cause disability — paralysis, muscle weakness, trouble speaking, memory loss — or death.

Peripheral artery disease (PAD) is the narrowing or blocking of the arteries carrying blood from the heart to the rest of the body, often by plaque. It is most common in the legs and lower body but can affect the arms. Typical signs: muscle pain during activity such as walking that eases quickly with rest; weakness or numbness in the legs that makes walking harder; or one arm or leg feeling colder than the other.

How smoking causes them

Cigarette smoking is a major cause of CVD and causes one of every four CVD deaths. Smoking can:

• raise triglycerides (a blood fat) and lower "good" cholesterol (HDL);
• make blood sticky and likely to clot, blocking flow to the heart and brain;
• damage the cells lining blood vessels;
• increase the buildup of plaque — fat, cholesterol, calcium and other substances;
• thicken and narrow blood vessels.

Secondhand smoke

Secondhand smoke — smoke from burning tobacco, and smoke breathed out by someone smoking — can cause coronary heart disease and stroke:

• nearly 34,000 early deaths from coronary heart disease a year among U.S. nonsmokers;
• 25–30% higher risk of heart disease for nonsmokers exposed at home or work, and 20–30% higher risk of stroke;
• more than 8,000 stroke deaths a year;
• it disrupts the heart, blood and blood vessels in ways that raise the risk of heart attack and stroke — and even brief exposure can damage vessel linings and make blood stickier, which can lead to a heart attack.

Prevention

Heart disease and stroke are major causes of death and disability, and many people at high risk don't know it — but many risk factors can be prevented or controlled. Know your risk and act on it. Start with the ABCS of heart health:

• Aspirin may lower the risk of heart disease and stroke — but talk to your doctor first, and don't take it if you think you're having a stroke, since it can make some strokes worse.
• Blood pressure: keep it under control.
• Cholesterol: manage it.
• Smoking: quit, or don't start.

Also: avoid secondhand smoke; eat fresh fruits and vegetables and mostly low-fat, low-salt foods; keep a healthy weight; be active regularly; limit alcohol; and keep other conditions, such as diabetes, under control.

A real story

Tammy W., a participant in CDC's Tips From Former Smokers campaign. CDC.

Tammy W. started smoking menthol cigarettes at 21. At 44 she learned she had heart disease and needed open-heart surgery, and she quit afterwards. If her story keeps even one person from smoking, she says, it will have been worth it — some losses can't be undone. More stories from CDC's Tips From Former Smokers: Brian H., Elizabeth B., Ethan B., Mariano Z., Noel S., Roosevelt S., Suzy E. and Tonya M..

Two more stories

• Tonya M. smoked for more than 23 years and was diagnosed with heart failure at 38. She now lives with a left ventricular assist device (LVAD) in her chest — a battery-powered pump that keeps her weakened heart moving blood through her body.
• Brian H. smoked heavily and had a heart attack at 35. He learned how much quitting — and staying quit — mattered; doing so eventually made him eligible for a heart transplant. On organ donation: organdonor.gov.

Free help to quit

Sources

Based on "Smoking and Heart Disease, Stroke, and Peripheral Artery Disease," Tips From Former Smokers, Centers for Disease Control and Prevention; a work of the United States government in the public domain. Tammy W.'s words are rewritten in hubnx's own words.