Tobacco Documents Online

Forum: Workshop on Carbon Monoxide and Cardiovascular Diseasel'O-~ .:! ' P J Berlin, October 10-12, 1978 Cosponsors American Health Foundation New York, New York Program ^Participants listed befolv are contributors to t/ris issue.^ Introduction Epidemiological Factors in Cardio- vascular Disease with Special Reference to Cigarette Smoking Epidemiology of Carbon Monoxide _in Cardiovascular Disease in Industrial Environments. Model Studies Linking Carbon Monoxide to Arteriosclerosis and Cardiovascular Disease Physiological Studies Linking Carbon Monoxide to Cardio- vascular Disease Methodological Aspects General Evaluation of the Role of Carbon Monoxide in the Patho- genesis of Arteriosclerosis and Cardiovascular Disease Summary of the Workshop I Federal Health OfFce Federal Republic of Germany Ernst L. Wynder Joseph T. Doyle Wilbert S. Aronow Carl Zenz Leslie W. Michael I//•.L. ,S; sl Poul Astrup and Knud Kjeldsen D. Ni. Turner Ronald F. Coburn Stephen M. Ayres, Robert G. Evans, and Meta E. Buehler Maurice Stupfel, Madeleine Mordelet- Dambrine, Andre Vauzelle and Arthur Perramon Dietrich Hoffmann, John D. Adams, and Ernst L. Wynder Dieter Borges and Burckhard Junge Gio B. Gori and Richard L. Ellis Walter M. Haag H. Schievelbein Henry C. McGill Gio B. Gori INTRODUCTION The purpose of this conference on carbon monoxide and cardiovascular disease is to review the current state of the art of the possible correlation existing among carbon monoxide, the pathogenesis of arteriosclerosis and/or the development of , 0091-7435/79- 0083 - 0oQOS 0? .OQ 0 Cop) nght 7' 1979 by AcaJcmK press. 1, . All rQhts of rcproCucnon in any form rexnc~t.

WORKSHOP: CARBON MONOXIDE AND CVD specific cardiovascular events. During this conference, we will review briefly the role of tobacco usage, particularly that of cigarette smoking, in the pathogenesis of cardiovascular events-an area which is so well documented that it does not require detailed reiteration on this occasion. It needs to be emphasized, however, that while tobacco smoking has been established as affecting the risk for develop- inM cardiovascular episodes, it wo-u d appear to do so onl in the presence o other major nsTctac""'Tors, pa cularCy that of hyperlipemia. Availa e eDt~em~lo oglcal ~ence, cr tnstance, indicates that in countries where the blood lipid levels are low,~ffect of cl arette smoklnl~ oit cardiovascu ar eyents is of_ relattygiy sma magnltu e. Therefore, any discussion on the role of cigarette smoking in genera and Me specific components of cigarette smoke in the etiology of cardio- vascular disease cannot be carried out without considering other risk factors. We are also reviewing the possible contribution of the occupational setting, particularly as it involves exposure to carbon monoxide as a risk factor for cardio- vascular disease. This is a somewhat more difficult undertaking since, in evaluat- ing the risk associated with a given occupation one also has to consider the prev- alence of other risk factors for which-data may not always be available. From epidemiological studies, we will proceed to clinical investigations and experimental studies. Our goal is to determine to what extent, and by what mechanisms, cigarette smoking (and which of its components) affect both the pathogenesis of artenosclerosis as well as specific cardiovascular events such as heart attacks, particularly when-they occur prematurely and suddenly, as well as such diverse events as peripFheral vascular disease and aortic aneurysm. We are fortunate to be able to bring together experts in these various areas from different parts of the world in order to debate issues that have both academic and public-health implications. Academically, we are interested in learning by which mechanisms cigarette smoking increases the risk of certain cardiovascular events. From a public health point of view such information is important because as we advance the field of less harmful smoking products we clearly require knowledge as to which products particularly need to be reduced, as well as whether any levels exist at which exposure to a given product would not likely result in adverse affects. We hope this conference will contribute to both of these issues and provide a basis upon which to undertake new research activities as well as to develop appropriate public health measures. Such measures, as indicated, require appro- priate knowledge in order to make recommendations pertinent, both from the point of view of being academically correct and of having the appropriate health consequences. Therefore, all of those working in the field of smoking and health issues, particularly those 4qVthe smoking and cardiovascular field, will look with interest toward these deliberations. It is an area that has been relatively neglected by both academic and scientific communities for reasons we have not always been able to understand fully. It is our hope that this workshop, with its delibera- tion and publication in Preventive Medicine, will rectify this problem. Finally, it has been asked why one should work on determining these agents in tobacco smoke which relate to disease and why, with such knowledge, one should work toward a less harmful cigarette. With the information available to ~--- ---- -------- ---- -f.~,o_ _ -_ ---- ---~ -l

. 00 0/. WORKSHOP: CARBON 16tON-OXIDE AND CVD -T- - - . us now, we know that if no one smoked, tobacco-related diseases would no longer be with us. As long as our society condones cigarette smoking, however, it is likely to be a habit that will be with us for the foreseeable future. It is for this reason that we must continue to work on identifying agents that relate to specific diseases with the hope that they can, and will, be reduced selectively in future tobacco products. This particular Conference hopes to contribute toward this end. ERNST L. WYNDER, M.D. President, Aiuericnn Health Foundation _1. 1 < M