Tobacco product usage is the single most preventable cause of death in the United States. Smoking promotes atherosclerosis, producing disease in the coronary arteries, the aorta, the carotid and cerebral arteries and the large arteries in the peripheral circulation. The cardiovascular consequences of tobacco products have been the subject of intensive study for several decades. Despite the overwhelming epidemiologic association between smoking and vascular disease, the pathophysiologic mechanisms by which smoking exerts its deleterious effects remain incompletely understood. This review addresses the acute and long-term systemic and coronary hemodynamic effects of tobacco, with an emphasis of the impact on coronary blood flow and pathophysiologic mechanisms.

烟草产品的使用是美国最可预防的单一死因。吸烟会促进动脉粥样硬化，导致冠状动脉、主动脉、颈动脉、脑动脉以及外周循环中的大动脉发生疾病。几十年来，烟草制品对心血管的影响一直是深入研究的主题。尽管吸烟与血管疾病之间存在压倒性的流行病学关联，但吸烟产生有害影响的病理生理机制仍不完全清楚。本综述讨论了烟草对冠状动脉血流动力学的急性和长期影响，重点是对冠状动脉血流和病理生理机制的影响。