Cardiovascular Diseases Clinical Trial
To determine the effects of long-term exposure to passive smoking on the cardiovascular and oxygen transport systems in pre-adolescent twins.
BACKGROUND:
The adverse health effects of actively inhaled cigarette smoke include impaired pulmonary
function, increased coronary and cerebrovascular disease, chronic pulmonary disease, and
cancer. Infants and young children of smoking parents are at increased risk for lower
respiratory tract infections and small airways disease than are children of non-smoking
parents. What is less clear is how the oxygen transport system of the growing child is
affected by the long-term exposure to and passive inhalation of cigarette smoke and if this
exposure represents a risk for the subsequent development of atherosclerotic heart disease.
DESIGN NARRATIVE:
A sample of 300 pre-adolescent twin pairs was recruited from an established population-based
twin study. The three cohorts of twins and their parents were initially evaluated in a
cross-sectional study and then followed longitudinally for up to three years. In the initial
testing cycle the following data were collected: genotype; general health; anthropometric
measures; resting and exercise noninvasive evaluation of hemodynamic parameters including
blood pressure, heart rate, cardiac output, left ventricular mass, and oxygen consumption;
hematocrit and blood levels of 2,3-DPG, cotinine, thiocyanate, and erythropoietin;
spirometric and pulmonary flow data; lipid levels. There were three follow-up exams. The
availability of repeated measures of oxygen delivery and its determinants in twins and their
parents permitted both a unique analysis of genetic and environmental factors during the
process of developmental change and measurements of the risks of accelerated
atherosclerotic/ischemic heart disease and of the development of reactive airway disease.
The following hypotheses were tested: genetic factors accounted for a significant proportion
of the variation in the hematologic and cardiovascular determinants of systemic oxygen
delivery; adaptive responses of the oxygen delivery system differed in the same individual
before and after puberty; passive smoking in children was an incremental risk factor for the
development of accelerated atherosclerotic/ischemic cardiovascular disease; passive smoking
in children was a contributing factor in the development of reactive airway disease.
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