Smoking causes surges in the concentrations of catecholamines (the stimulator chemical messengers of the autonomic nervous system) as well as increases in carbon monoxide in the blood. Both of these shortterm effects can exacerbate existing heart disease, resulting, for instance, in attacks of angina (chest pain).
Nicotine raises blood pressure and heart rate, requiring the heart to work harder. It also constricts the coronary arteries, thereby lessening the supply of blood and oxygen to the heart muscle. It also promotes irregular heartbeats (cardiac arrhythmias).
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