Associations of smoking behavior with measures of subclinical vascular brain injury and peripheral vascular function
Description: Cigarette smoking remains one of the most pervasive and preventable causes of vascular disease worldwide. Although smoking prevalence has declined, nearly 50 million adults in the United States continue to smoke, and millions more are former smokers who retain residual vascular risk. Growing evidence indicates that vascular injury occurs years before the onset of clinical symptoms and that early subclinical changes in brain structure and function may represent modifiable pathways to cognitive impairment and dementia. Within the vascular contributions to cognitive impairment and dementia framework, cigarette smoking is a potent vascular toxin that promotes endothelial dysfunction, large-artery stiffening, and impaired microvascular tone, hallmarks of accelerated vascular aging. However, the mechanisms linking smoking exposure to subclinical cerebrovascular injury remain poorly characterized, and the extent to which these effects are reversible with smoking cessation is unknown. We recently showed that measures of central arterial hemodynamics vary with smoking behavior and improve with longer cessation. Building on this work, we will leverage the longitudinal, community-based Framingham Heart Study to examine how cigarette smoking and cessation influence subclinical vascular brain injury, as well as peripheral vascular and microvascular function, and whether these associations operate through shared hemodynamic pathways. Aim 1 will relate smoking status, intensity, and cessation duration to cross-sectional and longitudinal changes in MRI-based measures of vascular brain injury. Aim 2 will assess whether smoking behavior and cessation patterns are associated with peripheral vascular and microvascular remodeling and dysfunction. By integrating cerebrovascular, peripheral vascular, and microvascular measures within a single, well-characterized cohort, this project will identify systemic vascular coupling mechanisms linking smoking to subclinical brain injury. The findings will clarify whether smoking-related vascular injury is reversible with cessation and advance the American Heart Association's mission to promote cardiovascular and brain health through prevention and risk factor modification.
Funder: American Heart Association
Amount: $99,550
Funding type: research
Funder scheme: Rapid Impact Research Award
Start date: 2026-04-01
End date: 2028-03-31
Investigators: Leroy Cooper, Leroy Cooper
Institution: Vassar College
Funded outputs count: 0
Funder award ID: 26RIRA1643879
OpenAlex ID: G5862357490