Smoking and cardiovascular disease

Undeniable evidence exists that both mainstream and environmental tobacco s moke causes cardiovascular disease. This article examines the epidemiology and pathophysiology of smoking-related cardiovascular risk and mechanisms f or initiation and promotion of atherogenesis. Clinical and experimental evi dence for actions on the myocardium, cellular blood constituents, serum lip oproteins, the artery wall, and vascular function are discussed. Furthermor e, the author considers consequences of smoking in women, including interac tions of smoking with sex hormones. Finally, strategies for enhancing educa tion, prevention, smoking cessation, and research efforts to lower smoking- associated cardiovascular disease risk are discussed.