4.5.4 - Smoking and disease

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Smoking damages the cardiovascular system in a number of ways:

  • Atherosclerosis- Cigarette smoke contains nicotine, which causes an increase in blood pressure. Increased blood pressure can cause damage to the arteries, leading to the formation of atheromas. When damage occurs to the lining of an artery, white blood cells move into the area. Over time more white blood cells, lipids and connective tissue build up and harden to form a fibrous plaque at the site of the damage- an atheroma. The atheroma partially blocks the lumen of the artery and restricts blood flow. Atherosclerosis is the hardening of arteries due to the formation of atheromas.
  • Coronary heart disease (CHD) - CHD is where the coronary arteries (arteries that supply blood to the heart) have lots of atheromas in them. This restricts blood flow to the heart. A reduction in blood flow reduces the amount of oxygen an area of the heart gets. This can cause pain (angina) or a heart attack. Smoking increases the risk of CHD because carbon monoxide irreversibly combines with haemoglobin, reducing the amount of oxygen transported in the blood, which reduced the amount of oxygen available to the tissues, including the heart. Also nicotine in cigarette smoke makes platelets (cells involved in blood clotting) sticky, increasing the chance of blood clots forming. If clotting happens in the coronary arteries, it could cause a heart attack. The presence of atheromas also increases the risk of clots forming
  • Stroke- A stroke is a


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