Cardiovascular disease (CVD) is among the leading causes of death globally, and the health care and social burdens of CVD are continuously increasing.¹ Smoking is a leading risk factor, and an important modifiable risk factor, for CVD.^1,2 Smoking causes more than 8 million deaths worldwide each year,³ and among adults aged 30 to 44 years who died from ischemic heart disease, 38% of the deaths were attributed to smoking.⁴ As smoking cessation may reduce CVD risk,^5,6 guidelines strongly recommend smoking cessation for primary and secondary prevention of CVD.^7,8 Due to smoking cessation counseling, nicotine replacement therapy, and medication, along with improvements in cultural and social awareness, the smoking rate, which was 32.7% of global adult population in 2000, decreased to 22.3% in 2020.⁴ Similarly, in South Korea, the smoking rate decreased from 25.8% in 2012 to 20.6% in 2020.⁹ However, the potential benefits of smoking cessation on CVD risk modification have not yet been fully elucidated, especially in terms of lifetime smoking burden (pack-years [PY]) and temporal changes in CVD risk.

There have been a few noninvasive studies showing the effect of aging on blood pressure (BP) and pulse wave velocity (PWV) in different arterial segments. The aim of this study was to evaluate the effect of aging on arterial hemodynamics in central and peripheral arteries using an invasive method. We observed 175 individuals undergoing coronary angiography. SBP and DBP were measured by pressure wave at the radial artery, abdominal aorta, and aortic arch. Aortic arch-abdominal aorta PWV (aoPWV) and aortic arch-radial artery PWV (arPWV) were also assessed by the foot-to-foot velocity method using a fluid-filled system. SBP and pulse pressure were significantly positively correlated and DBP was significantly negatively correlated with age through the arterial tree in a multivariate analysis after adjusting for sex, coronary artery disease, diabetes, dyslipidemia, smoking status, and the use of antihypertensive agents. Pulse pressure, SBP, and DBP were significantly associated with age (ranked in order of association strength) at all studied arterial segments. Each central BP showed a consistently higher correlation with age than radial BP. aoPWV and arPWV were also significantly correlated with age, and this relationship was much stronger for aoPWV (r = 0.474, P < 0.001) than for arPWV (r = 0.224, P = 0.003). The present invasive study suggests that aging has a greater effect on central rather than peripheral arterial hemodynamics. The central pulse pressure was the predominant BP affected by aging, which could be caused by the stronger relationship of aging with central arterial stiffness.