Environmental tobacco smoke promotes heart disease

Environmental tobacco smoke, a mixture of cigarette sidestream smoke (85%) and mainstream smoke (15%), originates from the smoldering end of a cigarette between puffs as well as exhaled tobacco smoke. It is responsible for involuntary or "passive" smoking by nonsmokers. Over the last 15 years, epidemiology and experimental studies have consistently shown that environmental tobacco smoke increases the risk of developing acute cardiovascular disease, acute myocardial infarction, sudden death, and stroke. Environmental tobacco smoke also produces chronic effects with atherosclerosis at epicardial coronary arteries, the aorta, the carotid cerebral arteries, and large arteries, in the peripheral circulation. These adverse effects are due to the effects of cigarette smoke on lipids, greater platelet aggregation, endothelial cell damage, and oxidant injury. This review will discuss the recent evidence linking mainstream and environmental tobacco smoke with cardiovascular disease, possible mechanisms by which environmental tobacco smoke causes cardiovascular disease, and the prospect for treatment using antioxidants.