Hypertension Research (2010) 33, 398–410; doi:10.1038/hr.2010.25; published online 9 April 2010

The effect of smoking on arterial stiffness

Robert J Doonan1, Anais Hausvater1, Ciaran Scallan1, Dimitri P Mikhailidis2, Louise Pilote1 and Stella S Daskalopoulou1

  1. 1Faculty of Medicine, Department of Medicine, McGill University, Montreal, Quebec, Canada
  2. 2Department of Clinical Biochemistry (Vascular Prevention Clinic), University College London Medical School, University College London (UCL), London, UK

Correspondence: Dr SS Daskalopoulou, Division of Internal Medicine, Department of Medicine, McGill University, McGill University Health Centre, Montreal General Hospital, 1650 Cedar Avenue, B2.236, Montreal, Quebec, Canada H3G 1A4. E-mail:

Received 23 November 2009; Revised 9 January 2010; Accepted 22 January 2010; Published online 9 April 2010.



A systematic literature review was conducted using PubMed, Embase and the Cochrane Library to determine the effect of acute, chronic and passive smoking on arterial stiffness and to determine whether these effects are reversible after smoking cessation. A total of 39 relevant studies were identified and included. Acute smoking was found to cause an acute increase in arterial stiffness. Similarly, passive smoking increased arterial stiffness acutely and chronically. The majority of studies identified chronic smoking as a risk factor for increasing arterial stiffness. However, some studies found no statistical difference in arterial stiffness between nonsmokers and long-term smokers, although chronic smoking seems to sensitize the arterial response to acute smoking. In addition, whether arterial stiffness is reversed after smoking cessation and the timeline in which this may occur could not be determined from the identified literature. The effect of smoking discontinuation on arterial stiffness remains to be established by prospective smoking cessation trials.


arterial stiffness; elasticity; pulse wave velocity; smoking; smoking cessation