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Il Cuore in Fumo: 25000 Ricoveri all’Anno in Piemonte

Pubblicato da Dr.Guidalberto Guidi in News · 12/12/2010 11:27:00
Tags: cuore, fumo, ricoveri, Torino
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%.

Proprio in questi giorni i dati sono stati resi ufficiali anche dall’Università di Torino e verranno presto estesi a tutto il territorio nazionale.

I ricoveri causati dal fumo di sigaretta in Piemonte sono circa 25.000 all’anno con una mortalità del 5%, gli infarti e le sindromi coronariche acute sono circa 5.000. Da ciò si deduce 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.

Il fumo di sigaretta provoca una sorta di asfissia cellulare e produce notevole quantità di radicali liberi, ogni sigaretta forma circa 10 miliardi di radicali liberi. L’azione dei radicali liberi si manifesta sulle proteine che trasportano grassi e colesterolo, chiamate LDL, che vengono ossidate, provocando vasocostrizione (riduzione di diametro dei vasi), aumento dell’adesività dei globuli bianchi e dell’aggregazione piastrinica che dà inizio al processo di trombosi e di aterosclerosi. Ogni lipoproteina LDL contiene 2.000 molecole di grassi!

Quando sono aggredite dai radicali liberi prodotti dal fumo si ossidano, formando le ox-LDL, estremamente tossiche perchè si infiltrano e accumulano nella parete dei vasi come cellule grasse, che cresceranno a dismisura.

Il trasporto di ox-LDL a livello della parete arteriosa è ormai riconosciuto come evento specifico e fondamentale della formazione del mantenimento dell’aterosclerosi. Il danno sulla parete interna dei vasi, conseguente all’azione lesiva delle ox-LDL, gioca un ruolo decisivo nel successivo sviluppo dell’aterosclerosi, successiva ischemia, infarto e ictus.

Ogni sigaretta può provocare uno spasmo vascolare nei vari distretti, sia cerebrale che 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 e interruzione del flusso sanguigno.

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.

E’ stato calcolato che il danno provocato da una sigaretta richiede circa 2 ore per essere faticosamente neutralizzato dalle naturali difese dell’organismo, che è costretto a utilizzare tutti i suoi antiossidanti endogeni.

Questo meccanismo non è infinito e andrà così ad esaurirsi lasciando i vasi sanguigni in balia dell’asfissia e dello stress ossidativo, con conseguenze anche gravi per l’apparato cardiovascolare e polmonare.

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