Relationship of smoking and smoking cessation with ankle-to-arm blood pressure index in elderly Japanese men

Background Cigarette smoking is associated with an increased risk of peripheral arterial disease, but the relationship between smoking cessation and preclinical peripheral atherosclerosis is uncertain. Design and methods A cross-sectional, population-based study to examine the effect of smoking and smoking cessation on the prevalence of peripheral arterial disease among 1215 men aged 60-79 years in two Japanese communities in 1999-2000. The ankle-to-arm systolic blood pressure index (AAI) was used as an estimate of the presence of peripheral atherosclerosis. Results The mean AAI correlated inversely and linearly with smoking status and pack-years of smoking. The multivariate prevalence odds ratio [95% confidence interval (CI)] of low AAI (<0.90) compared with never-smokers was 3.7 (95% Cl 1.1 -12.7) for current smokers and 4.2 (95% Cl 1.2-14.6) for men with 45 or more pack-years of smoking. In men who have quit smoking for 20 years or more, the mean AAI was higher and the prevalence of low AAI (< 0.90) was lower than those of current smokers, but similar to those of never-smokers. Conclusions Our results confirm that current smoking and pack-years of smoking correlate with the presence of peripheral artery disease. The results suggest that smoking cessation for 20 years or more is associated with the regression of atherosclerosis in peripheral arteries. This finding needs to be confirmed by a prospective study.