Peripheral Vascular Disease

Smoking is strongly associated with other forms of cardiovascular disease, including abdominal aortic aneurysm (AAA) and peripheral vascular disease in both men and women. Smoking causes as much as half of all peripheral artery disease, and significantly increases the failure rates after lower-limb bypass surgery. The risk of AAA rises in proportion to duration and intensity of smoking and is up to sevenfold greater at 20 pack-years (US Surgeon General, 2004). The U.S. Preventive Services Task Force (USPSTF) has recommended one-time screening for AAA by ultrasonog-raphy in men age 65 to 75 who have ever smoked. Consideration should also be given for screening women over age 65 with a history of smoking (Derubertis et al., 2007), because about 40% of the annual deaths from AAA occur among women, in whom the disease is more deadly than men. Smoking is also an independent risk factor for erectile dysfunction, an additional fact that may help motivate men to stop smoking.

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