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Binge drinking or smoking stiffens arteries in teenagers

Research in Europe has found that the arteries of teenagers who binge drink or smoke are already stiffer by the age of 17 than in those who abstain, The Guardian reports. Arterial stiffness indicates damage to the blood vessels.

Research in older adults has previously shown that the stiffening of arteries is linked to heart and circulatory disease and an increased risk of events such as heart attack or stroke. While our arteries stiffen as we age, it is known that a host of behaviours are linked to the effect, including cigarette smoking and excessive drinking.

“This is the sort of pattern of drinking that is common in young people and the smoking was light – so this is applicable probably to the behaviour of many young people in the population today,” said John Deanfield, professor of cardiology at University College London and a co-author of the study.

The report says the research comes days after another study found there is no “healthy level” of alcohol consumption. “(That study) says that alcohol is bad for you – and we are saying it is bad for you from very early on,” said Deanfield.

The team of researchers from the UK and Sweden have described how they made the link through a long-term study known as the Avon Longitudinal Study of Parents and Children. In total, 1,266 participants were asked at age 17 about their smoking status and had the stiffness of their arteries assessed using a non-invasive device. Of these participants, almost 1,100 provided information on their drinking habits at 17, while data on drinking at ages 13 and 15 was also available for just over 1,000 of the teens. Similar data on smoking habits from age 13 was available for 661 participants.

The report says the results reveal that, at 17 years, 23.8% of participants were smokers. Meanwhile, more than three quarters of the teens drank between three and nine alcoholic drinks on a typical day that they were consuming alcohol – and more than 10% said they drank even more than that.

The team found that 17-year-olds who currently smoked had significantly stiffer arteries than those who did not, while those who had smoked 100 or more cigarettes in their life had stiffer arteries than those who had smoked fewer than 20.

The team found that the earlier participants began smoking, the worse the effect on their arteries – provided they continued to smoke. However, teens who smoked but then quit had arteries of a similar stiffness to those who had never smoked. That, said Deanfield, suggests the impact could be reversible.

The researchers found no link between artery stiffness and the age at which drinking began or how frequently individuals drank. However, those who engaged in high intensity drinking had stiffer arteries, even after factors such as BMI and cholesterol levels were taken into account.

“If young people smoked and drank, the impact on their arteries was greater than (for) either risk factor alone,” said Deanfield.

The study had limitations including that the data is based on self-report, which can be inaccurate and the study can only reveal links, rather than attributing a cause. Since the study only began in 1991, it is also not clear whether arterial stiffness will affect the teens’ future risk of cardiovascular problems.

Dr Henry Boardman, cardiology consultant at Milton Keynes University Hospital who was not involved in the study, is quoted in the report as saying that while the levels of arterial stiffness found in the teens were not dangerous, the trends uncovered are important.

“It is telling us that there is no safe age to have these ‘bad’ lifestyle habits of alcohol excess, or binge drinking, and smoking – but there is some data from this study that if you stop smoking these changes go away,” he said, adding that it also shows that such changes start earlier than previously thought.

Abstract
Aims: To determine the impact of smoking and alcohol exposure during adolescence on arterial stiffness at 17 years.
Methods and results: Smoking and alcohol use were assessed by questionnaires at 13, 15, and 17 years in 1266 participants (425 males and 841 females) from the ALSPAC study. Smoking status (smokers and non-smoker) and intensity (‘high’ ≥100, ‘moderate’ 20–99, and ‘low or never’ <20 cigarettes in lifetime) were ascertained. Participants were classified by frequency (low or high) and intensity of drinking [light (LI <2), medium (MI 3–9), and heavy (HI >10 drinks on a typical drinking day)]. Carotid to femoral pulse wave velocity (PWV) was assessed at 17 years [mean ± standard deviation and/or mean difference (95% confidence intervals)]. Current smokers had higher PWV compared with non-smokers (P = 0.003). Higher smoking exposure was associated with higher PWV compared with non-smokers [5.81 ± 0.725 vs. 5.71 ± 0.677 m/s, mean adjusted difference 0.211 (0.087–0.334) m/s, P = 0.001]. Participants who stopped smoking had similar PWV to never smokers (P = 0.160). High-intensity drinkers had increased PWV [HI 5.85 ± 0.8 vs. LI 5.67 ± 0.604 m/s, mean adjusted difference 0.266 (0.055–0.476) m/s, P = 0.013]. There was an additive effect of smoking intensity and alcohol intensity, so that ‘high’ smokers who were also HI drinkers had higher PWV compared with never-smokers and LI drinkers [mean adjusted increase 0.603 (0.229–0.978) m/s, P = 0.002].
Conclusion: Smoking exposure even at low levels and intensity of alcohol use were associated individually and together with increased arterial stiffness. Public health strategies need to prevent adoption of these habits in adolescence to preserve or restore arterial health.

Authors
Marietta Charakida, George Georgiopoulos, Frida Dangardt, Scott T Chiesa, Alun D Hughes, Alicja Rapala, George Davey Smith, Debbie Lawlor, Nicholas Finer, John E Deanfield

[link url="https://www.theguardian.com/science/2018/aug/28/study-of-teenage-drinkers-and-smokers-shows-significant-damage-to-arteries"]The Guardian report[/link]
[link url="https://academic.oup.com/eurheartj/advance-article/doi/10.1093/eurheartj/ehy524/5079246?searchresult=1"]European Heart Journal abstract[/link]
[link url="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)31310-2/fulltext"]Global Burden of Disease study in The Lancet[/link]

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