Smoking Is a Risk for Peripheral Artery Disease

By Sherry Baker @SherryNewsViews
July 24, 2023
Smoking Is a Risk for Peripheral Artery Disease

Researchers have found that smoking is a stronger risk for peripheral artery disease than for heart attacks and stroke. That’s yet another reason to quit smoking.

If you smoke, you no doubt already know you are not doing your lungs any favors. You’re raising your odds of developing lung cancer and chronic obstructive pulmonary disease.

You are also at elevated risk for heart attacks and strokes. Johns Hopkins Bloomberg School of Public Health researchers have also identified an even stronger health risk linked to smoking ― peripheral artery disease.

Your risk can remain elevated even 30 years after you quit. But that doesn’t mean you should continue to smoke. Kicking nicotine addiction will begin to lower your odds of developing the disease. And if you already have the condition, smoking cessation and other lifestyle changes can help prevent serious complications.

That’s yet another reason to stop smoking.


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The peripheral artery disease and smoking connection

Plaque is fatty, artery-clogging material made up of cholesterol, calcium, fibrous tissue, and other substances in your blood. Atherosclerosis develops when plaque builds up in arteries carrying blood to your brain and heart. It can cause strokes, transient ischemic attacks, and heart attacks. When it builds up in your leg arteries, the result is peripheral artery disease.

The disease limits flow of oxygen-rich blood to your limbs, causing numbness and pain, which can limit your ability to exercise or even walk up and down stairs. The poor circulation resulting from peripheral artery disease can also put you at risk for leg infections, including hard-to-treat ones.

In fact, if blood flow to a limb is blocked badly enough, gangrene (tissue death) may develop, requiring leg amputation, according to the National Heart Lung and Institute (NHLBI).

The Johns Hopkins study, published in the Journal of the American Heart Association (JAMA), analyzed smoking and atherosclerotic disease in a large group of people participating in the ongoing, long-term Atherosclerosis Risk in Communities (ARIC) study.

To look for smoking-elevated risks of coronary artery disease, stroke, and peripheral artery disease, the investigators studied ARIC data from 13,335 people (including 3,323 current smokers and 4,185 former smokers) collected over the course of 26 years.

The research team used “pack-years” to measure how much and how long people smoked. For example, 10 pack-years can mean smoking one pack of cigarettes per day for 10 years or smoking two packs daily for five years, or some other combination. The results showed people who smoked for more than 40 pack-years had 1.8 times more risk for stroke and 2.1 times the risk for coronary artery disease compared to people who never smoked.

But the risk for peripheral artery disease was even higher. The 40-pack years smokers had about four times the risk than non-smokers.

This is another reason to stop smoking

The smoking risk for peripheral artery disease wasn’t only stronger than the risk for stroke or heart attack, it lasted longer, too. It takes about 30 years of smoking cessation for the risk for former smokers to become as low as the risk for people who never smoked.

That said, giving up cigarettes results in a meaningful drop in peripheral artery disease fairly quickly.

"We observed a lower risk for peripheral artery disease, coronary artery disease, and stroke within five years of smoking cessation," said researcher Ning Ding, a data analyst at the Bloomberg School and first author of the study.

The research team found that people who stopped smoking for five to nine years had a 57 percent reduction in their peripheral artery disease, along with a 30 to 40 percent drop in risk for coronary artery disease and stroke.

How to prevent peripheral artery disease

"Our results underscore the importance of both smoking prevention for non-smokers and early smoking cessation for smokers. The study also suggests that campaigns about smoking's health risks should emphasize the elevated risk of peripheral artery disease, not just coronary heart disease and stroke," said researcher and epidemiologist Kunihiro Matsushita, MD, PhD.

If you have leg pain when you walk or climb stairs, especially if you have a history of smoking, don’t assume it’s a normal part of aging. Talk to your doctor about being tested for peripheral artery disease, the NHLBI emphasizes. A simple, non-invasive test, called an ankle-brachial index, can determine whether you have the condition.

If you do smoke, you have another reason to quit smoking. Work with your doctor on a successful smoking cessation plan to lower your risk. If you already have the condition, lifestyle changes — including losing excess weight, getting regular exercise, eating a heart-healthy diet and stopping smoking — can help lower your risk for serious complications.


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July 24, 2023

Reviewed By:  

Janet O’Dell RN