吸烟与心血管疾病概述吸烟是中国人心血管疾病的重要危险因素冠心病—是吸烟致死疾病的前三位之一内皮功能紊乱血栓生成增加炎症反应加强氧化修饰组织因子（TF）在动脉粥样硬化斑块有高表达，这可能在血栓形成中发挥重要作用TF水平以Xa因子(FXa)进行评价吸烟者与非吸烟者比，循环中TF活性远高于后者Baruaetal.Circulation.2001;104:1905-1910.Zeiheretal.Circulation.1995;92:1094-1100.Lavietal.Circulation.2007;115:2621-2627.ns=notsignificant.aUnlessmarkedas“ns,”differencesforeachvaluebetweengroupswerestatisticallysignificantatalevelofP<.05.Schmidetal.ThrombRes.1996;81:451-460.异构前列腺素F2水平是体内脂质过氧化反应的指标Thedotsrepresentingsubjectswhosmokedareeachconnectedtoadotrepresentinganonsmokermatchedtothesubjectforageandsex.AdaptedfromMorrowetal.NEnglJMed.1995;332(18):1198-1203.吸烟与心血管疾病的流行病学吸烟与冠心病(CAD)Watersetal.Circulation.1996;94:614-621.aTheprobabilityofanevent(developingadisease)occurringinexposedpeoplecomparedwiththeprobabilityoftheeventinnonexposedpeople.Adjustedforage.Willettetal.NEnglJMed.1987;317(1):1303-1309.与非吸烟者相比，吸烟者发生急性非致死性心梗的风险增加3倍。YusufSetal.Lancet.2004;364:937-52aTheprobabilityofanevent(developingadisease)occurringinexposedpeoplecomparedwiththeprobabilityoftheeventinnonexposedpeople.Adjustedforage.Willettetal.NEnglJMed.1987;317(21):1303-1309.aTheprobabilityofanevent(developingadisease)occurringinexposedpeoplecomparedwiththeprobabilityoftheeventinnonexposedpeople.Adjustedforage.Wannametheeetal.Circulation.1995;91:1749-1756.aTheprobabilityofanevent(developingadisease)occurringinexposedpeoplecomparedwiththeprobabilityoftheeventinnonexposedpeople.Adjustedforthebaselinevariablessignificantlyassociatedwitheachendpoint.Hasdaietal.NEnglJMed.1997;336:755-761.被动吸烟与冠心病Adjustedforage,systolicbloodpressure,diastolicbloodpressure,totalcholesterol,HDLcholesterol,FEV,height,preexistingCAD,bodymassindex,triglycerides,whitecellcount,diabetes,physicalactivity,alcoholintake,andsocialclass.aLightactivereferstomensmoking1-9cigarettesaday.bHeavypassivereferstoupperthreequartersofcotinineconcentrationcombined(0.8to14.0ng/mL).cLightpassivereferstolowestquarterofcotinineconcentrationamongnonsmokers(0-0.07ng/mL).Whincupetal.BMJ.2004;329: