Background: We hypothesized that arterial wall thickening, an early atherog
enic alteration, might be associated with smoking differently according to
gender, considering the cardiovascular protection of female sex hormones. M
ethods and results: We measured ultrasonographically carotid and femoral in
tima-media thickness (IMT) in 194 men and 330 women without risk factors ot
her than smoking. In men: (i) current smokers had greater carotid and femor
al IMT (P < 0.01, P < 0.001) and former smokers had greater femoral IMT (P
< 0.01) than never smokers; (ii) in pooled never, current and former smoker
s carotid and femoral IMT correlated to current daily smoking (P < 0.01) an
d lifelong smoking (P < 0.001); and (iii) carotid and femoral IMT correlate
d to age in never smokers (P < 0.001), current smokers (P < 0.01, P < 0.001
) and former smokers (P < 0.01), with greater slopes in current than in for
mer smokers at carotid site (P < 0.05) and in current than in never smokers
at femoral site (P < 0.05). In women: (i) IMT did not differ by smoking st
atus; iii) in Fooled smokers and non smokers femoral IMT correlated to curr
ent daily smoking (P = 0.01) and to lifelong smoking (P < 0.01) with a lowe
r slope than in men (P < 0.001), while carotid IMT did not; and (iii) carot
id and femoral IMT correlated to age in never smokers (P ( 0.001), current
smokers (P < 0.001, P < 0.05) and former smokers (P < 0.001, P < 0.01) with
no different slopes. Conclusion: Smoking-related increase in IMT existed i
n men but not in women, suggesting a possible protection of female gender f
rom early structural arterial alteration of smoking. (C) 2000 Elsevier Scie
nce Ireland Ltd. All rights reserved.