Mancia · Clinical and experimental hypertension. Part A, Theory and practice 1990 · narrative review · n=?

Cardiovascular effects of smoking.

Cited 44 times in the scientific literature.

Level 5 - mechanism / opinion, no new human data

Narrative review detailing mechanisms of cardiovascular risk without primary data or systematic methodology

PubMed 2208758 · doi:10.3109/10641969009073509 · record verified 2026-08-29

What was done

This is a narrative review summarizing mechanisms by which cigarette smoking affects the cardiovascular system, its interaction with other major risk factors, and its autonomic mediation.

What was found

The abstract reports no quantitative data or specific effect sizes. It describes that smoking interacts with hypercholesterolemia and hypertension to raise coronary heart disease incidence in a greater-than-linear manner. Mechanistically, it notes adverse effects on plasma fibrinogen, platelet turnover, and lipid profiles, alongside nicotine-mediated sympathetic activation that produces acute bradycardia, elevated blood pressure, and vasoconstriction. It states that these autonomic effects can lead to permanent blood pressure elevation in heavy smokers, which is only partially mitigated by beta-blockers alone and requires combined alpha- and beta-blockade to abolish.

Why it matters

It outlines how nicotine-driven sympathetic activation and hematologic changes jointly accelerate cardiovascular disease, illustrating why multiple cardiovascular risk factors multiply rather than simply add to overall risk.

Limits

As a narrative review from 1990, the abstract provides no primary data, sample sizes, search strategy, or quantitative risk estimates. Some physiological assertions (such as smoking-induced acute bradycardia, which typically presents as acute tachycardia) are stated without context or data in the abstract.

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