Circulatory disorders caused by smoking


Smoking cigarettes or other tobacco products brings many health risks with it.

In addition to the loss of lung function and other consequential damage, circulatory disorders can develop.
With circulatory disorders, areas of the body are no longer adequately supplied with blood, which damages the tissue. In most cases, this is due to changes in the vascular system, which the blood can no longer completely or, in the worst case, no longer conduct.

Other causes of circulatory disorders are high blood pressure, diabetes and other metabolic diseases. While the factors mentioned so far represent diseases that can be treated but are not in the patient's hands, smoking and an unhealthy diet are among the causes that can be influenced.
Every smoker has to decide for himself, but also for people in his immediate vicinity, whether it is worthwhile to keep this vice, which is dangerous to health. In principle, it is not advisable to consume tobacco products.

You might also be interested in this topic: Consequences of smoking

Development of circulatory disorders

Smoking tobacco produces various gases that are inhaled.
One of the gases is carbon monoxide (CO). This is deposited on the red blood cells in the blood, the so-called Erythrocytes. Usually tie Erythrocytes the oxygen that the lungs absorb when you breathe. The lack of oxygen caused by those occupied with carbon monoxide Erythrocytes arises, is measured in the body and communicated to the brain. This is done via the so-called carotid body - a measuring station in the carotid artery (common carotid artery) - in which the concentration of carbon dioxide (CO2) is created by metabolism in the body and is exhaled through the lungs) and oxygen (O2) as well as the pH -Value of the blood is registered. Due to the unavailable red blood cells The brain signals to the bone marrow that there is a deficiency and encourages new growth.
This will increase Erythrocytes and the hematocrit, the percentage by volume of blood cells in the blood, increases. This thickens the blood.

In addition to influencing blood formation, the involuntary (vegetative) nervous system is stimulated. This releases stress hormones - adrenaline and noradrenaline. These put the body in an activated state. Part of the activation is the narrowing of the blood vessels in the body (vasoconstriction), which increases blood pressure.

Furthermore, the blood lipid values ​​change. The concentration of harmful LDL cholesterol increases due to the lack of oxygen in the tissue and it is increasingly deposited in the vascular wall. This is usually the beginning of arteriosclerosis, a pathological narrowing of an artery due to fat deposits and subsequent calcification of the damaged vessel wall.
This increases the risk of a blood clot, called a blood clot, forming in the vessel thrombus.
HDL cholesterol, popularly known as the "good cholesterol", is produced less by smoking. As a result, its useful function of inhibiting the storage of LDL cholesterol is lost and additionally increases this negative effect.

Smoking also affects the coagulation system. Fibrinogen is increasingly formed. Fibrinogen is the precursor to fibrin, one of the coagulation factors. Due to the increased release, the tendency of the blood to clot increases, which means that unnecessary and spontaneous thrombus formation can occur, which, depending on the size of the vessel, leads to its closure. The formation of a blood clot is caused by the increased networking of the blood platelets (Platelets), which are involved in blood coagulation to a large extent. Overall, the concentration of fibrinogen influences the flowability (viscosity) of the blood. This factor can also lead to blood thickening.

All mechanisms of formation have one thing in common: their effect on the vascular system. Smoking increases blood pressure, the vessels contract and are also narrowed by arteriosclerotic processes. The latter effect plays the greatest role in the manifestation of the circulatory disorder. Since the vascular system has many interconnected conduction pathways (Anastomoses), the occlusion of individual arteries is in most cases not yet noticed. Only when the majority of the accesses are stenosed (closed) do noticeable circulatory disorders due to smoking occur.

Read more on the topic: Circulatory disorders of the hands

Disease mechanism

The basic mechanism by which circulatory disorders damage tissue is obvious. Due to the insufficient blood supply, both too few nutrients and too little oxygen are transported to the cells. The cells need oxygen for a functioning metabolism and sufficient energy production.
Most cells in the body, especially muscle cells, are able to withstand this kind of undersupply for a while. Sooner or later, however, irreversible damage occurs: the cells have used up their resources and die. This is the process of necrosis. In addition to apoptosis, this is one of the two ways in which a cell can perish.
While apoptosis represents the targeted death of a cell (due to age or inability to function - mediated by the body or the immune system), poisons are released in necrosis because cell aggregates are involuntarily destroyed. The immune system does not have the opportunity to purposefully render the toxins harmless.
The body is flooded with the pollutants and the immediately surrounding tissue is damaged, which can progress the necrosis.


The mechanisms that have so far been described for the development of circulatory disorders caused by smoking describe the development of a clinical picture - that of peripheral arterial occlusive disease (PAOD).
This is the progressive narrowing and ultimately the closure of arteries in the extremities (arms and legs). The condition, also known as intermittent claudication, occurs mainly in people over the age of 50, with men more frequently affected than women. The main cause of PAOD is arteriosclerosis, which is strongly promoted by smoking.
A smoker has a four times higher risk than a non-smoker and usually falls ill 10 years earlier than other patients. The extent of the PAOD depends on the level of tobacco consumption.

Further information on this topic can be found at: The smoker's leg - the peripheral arterial occlusive disease

Localization of the circulatory disorder

The vascular damaging processes caused by smoking can manifest themselves in the entire vascular system, but increasingly appear in the extremities. The upper extremities, i.e. arms, hands and fingers in particular, can be affected. Also possible and more often the case is a disease of the lower extremities - the legs, feet and toes.

Circulatory disorder of the upper extremity:

If the changes are limited to small vessels in the fingers, the result can be relatively unspecific symptoms. Patients often report that their hands are constantly cold and that they feel pain after long, monotonous work with their fingers, such as when writing.

Subclavian steal syndrome is a narrowing or occlusion of the subclavian artery, which arises from the aorta and supplies the arms with blood. Blood backflows from the vertebral artery, which branches off the subclavian artery and normally carries blood from it to the brain. This is made possible by the closed blood circulation that exists between the arteries and the brain.
If the blood now flows back because the arm on which the subclavian artery is closed also needs to be supplied, the blood in the brain is missing. You may experience dizziness attacks. In addition, patients report pain in the affected arm and rapid onset of muscle fatigue.

Also read the article on the topic: Circulatory disorder in the arm

Circulatory disorder of the lower extremity:

Classic PAD in the legs occurs more frequently in the thigh area. Patients usually feel severe pain in their legs after walking for a short distance and have to take a break.
In the case of diabetic causes or circulatory disorders caused by smoking, the tissue on the foot is more likely to be affected.
Cold feet can also be a sign of an illness if they are more frequent.

The so-called chronic critical limb ischemia (Ischemia = Reduced blood flow) occurs mainly in the lower extremities and manifests itself through various symptoms.
The clinical picture is defined by persistent pain at rest and / or inflammation of the skin in the undersupplied area.
Since the skin cells are furthest away from the vessels, they are the first to perish in an ischemic state. If no treatment is initiated, gangrene develops: the tissue dies, turns black and shrinks. This condition is also known colloquially as the smoker's leg.
The dead tissue includes not only the skin, but also all of the underlying layers - the subcutis and muscles. The border of the necrotic area moves ever higher and can thus, if the patient remains alive, increasingly occupy the entire foot and leg.
The last resort to stop this process is usually only to amputate the affected limb.

Read our article about: Burning toes!

For the most important information on the subject of "Circulatory disorders in the toes", please also read the following article: Circulatory disorder in the toes

How does smoking affect blood flow in the brain?

As in all other parts of the body, there is also an increase in deposits, arteriosclerosis and calcification in the blood vessels of the brain. This worsens the blood flow to the brain. It increases the risk of a stroke.This occurs when the blood supply in a brain supply is no longer sufficient and the affected brain cells no longer function.
Various functional failures occur depending on the area affected. The poorer blood circulation can also manifest itself in a lower ability to perform and concentrate.

How does smoking affect potency?

Studies have found a clear link between smoking and erectile dysfunction. Smokers are about 50% more likely to suffer from impotence than non-smokers. It was also found that particularly heavy cigarette consumption is associated with more pronounced erectile dysfunction. The reason for this lies in the deteriorated supply of oxygen and nutrients to the penis. This is because smoking leads to a narrowing of the penile artery due to deposits.
Because of this, not enough blood can get into the erectile tissue of the penis for an erection. In addition, fertility is reduced in smokers because the sperm are smaller and move less. However, impotence is a long-term consequence of smoking. It only occurs after several years. After quitting smoking, there is a significant improvement in erection problems.

How does smoking affect blood flow to the hand / finger?

The blood circulation in the hand or fingers is also worsened due to smoking. The blood circulation is impaired by calcification and arteriosclerosis of the blood vessels. As a rule, however, the symptoms are not as pronounced here as in other parts of the body. Even so, symptoms can occur due to the deteriorated blood supply. The complaints are quite unspecific. Due to the poorer blood circulation, less heat reaches the hands and fingers, so that they get cold more often and more quickly.

Also read the article on the topic: Circulatory disorder in the arm

Therapy circulatory disorders

In order to contain the circulatory disorders, it is essential to stop smoking. All other therapeutic measures are of no use if the damage to the vascular system is promoted in addition to the treatment.
Basically, through a change in diet, a lot of exercise and tobacco abstinence, the stagnation of the vascular changes can be achieved. Blood flow can be improved by using anticoagulants, but the drugs in turn have undesirable side effects.

If the narrowing has progressed too far, interventional or surgical treatment can be considered.
For example, it is possible to expand the stenosed site with a balloon stent and keep it open, or to create a bypass to a healthy vessel. These methods are known to most as interventions for occlusion of the coronary arteries (heart attack).

Read more about the topics: Therapy of circulatory disorders and medication circulatory disorders