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Il Fumo fa male anche al cuore

Pubblicato da Dr.Guidalberto Guidi in Fumo · 1/6/2018 10:23:00
Tags: fumodannicuorecardiologocardioexperttabaccoipertensione

I danni da fumo sono associati sempre ai polmoni, ma in realtà il fumo è la seconda causa di malattie cardiovascolari dopo l’ipertensione.
Oggi, 31 maggio, si celebra la Giornata Mondiale senza tabacco, istituita dall’OMS esattamente trent’anni fa, nel 1988.
In Italia i fumatori sono quasi 12 milioni, più del 22% della popolazione e ogni anno si contano tra i 70mila e gli 83mila decessi causati dal fumo.

I nuovi dati incoraggianti
Per la prima volta dal gennaio 2005, anno in cui entrò in vigore la legge che vietava il fumo nei locali pubblici, possiamo fare un bilancio sicuramente positivo, con una riduzione di eventi cardiovascolari e infarti di circa il 10%.
A breve conosceremo i dati aggiornati a livello nazionale, ma intanto in Piemonte, la mia regione, i ricoveri causati dal fumo di sigaretta si attestano su circa 25.000 all’anno con una mortalità del 5%, gli infarti e le sindromi coronariche acute sono circa 5.000.

Non bisogna abbassare la guardia
I dati sono incoraggianti, ma non soddisfacenti, con un costo sociale e di vite umane inaccettabile.
Ribadendo il concetto di prevenzione, dobbiamo ricordare come l’astensione dal fumo sia socialmente utile ed estremamente economica, praticamente “a costo zero”, rispetto a terapie farmacologiche.
Perché la prevenzione sia e continui ad essere efficace è necessaria la consapevolezza, da parte dei fumatori e di coloro che devono conviverci, dei meccanismi che portano ai devastanti effetti sulla salute.

Lo spasmo vascolare da sigaretta
Ogni sigaretta può provocare uno spasmo vascolare nei vari distretti, sia cerebrale sia coronarico, e questo è stato dimostrato nel corso di coronarografia dagli studi condotti da ricercatori italiani. Se lo spasmo si manifesta su un vaso sano non vi sono conseguenze serie, se invece avviene su un vaso già compromesso, per esempio in corrispondenza di una placca aterosclerotica, le conseguenze possono essere anche gravi fino alla completa ostruzione del vaso ed interruzione del flusso sanguigno con conseguente infarto o ictus.

La disfunzione endoteliale
Un ulteriore meccanismo lesivo del fumo è quello che si manifesta cronicamente sulla superficie interna dei vasi, una sorta di infiammazione chiamata disfunzione endoteliale, e contemporaneamente sui fattori della coagulazione: da un lato indebolisce lo strato protettivo interno a diretto contatto con il sangue, dall’altro aumenta la coagulabilità del sangue e riduce i fattori antitrombotici, facilitando così i meccanismi della trombosi.

A lungo andare l’organismo non ce la fa più
È stato calcolato che il danno provocato da una sigaretta richiede circa 2 ore per essere neutralizzato dalle naturali difese dell’organismo, costretto a utilizzare tutti i suoi antiossidanti endogeni. Questo meccanismo non è infinito e andrà così a esaurirsi lasciando i vasi sanguigni in balia dell’asfissia e dello stress ossidativo, con conseguenze anche gravi, talvolta letali, per l’apparato cardiovascolare e polmonare.
La colpa, ovviamente, è delle sostanze che si sprigionano con la combustione del tabacco, soprattutto il monossido di carbonio che provoca un’insufficiente ossigenazione dei tessuti.

Non è mai troppo tardi per smettere
In conclusione, ribadiamo che fumare o subire passivamente il fumo fa restringere o dilatare vene e arterie, aumenta la pressione sanguigna e accelera la formazione di placche nei vasi. Per questo chi fuma ha più possibilità di avere infarti, ictus cerebrali e aterosclerosi.
Non è mai troppo tardi per smettere.



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