Revista JRG de Estudos Acadêmicos · Nov 6, 2026
Acceleration of atherosclerosis and vascular age in individuals younger than 45 years: influence of smoking and Western dietary patterns
By Pinto CFDC, One GMDC, Estrela YDCA et al.
Cardiovascular diseases (DCVs) are the leading cause of morbidity and mortality worldwide, with an increasing incidence in young adults that signals a critical epidemiological transition. This phenomenon is driven by the acceleration of atherosclerosis, a pathophysiological process resulting from continuous exposure to modifiable risk factors, especially smoking and Western dietary patterns. This study aimed to analyze the scientific evidence regarding the influence of smoking and the Western diet on the acceleration of subclinical atherosclerosis and the increase in vascular age in individuals younger than 45 years. This is a systematic literature review, applied in nature, with a qualitative approach and a descriptive-analytical objective, conducted according to the recommendations of the PRISMA 2020 checklist and structured using the PICO strategy. The literature search was conducted in the PubMed, SciELO, and LILACS databases (2016–2026), using MeSH/DeCS descriptors combined with Boolean operators. A total of 30 records were identified, of which 7 high-impact original studies met all inclusion criteria after screening and risk-of-bias assessment (NOS and JBI scales). The results demonstrated that smoking is associated in a dose-dependent manner with endothelial dysfunction, elevated high-sensitivity C-reactive protein (PCR-us), greater carotid intima-media thickness (CIMT), and greater pulse wave velocity (VOP). The Western diet, rich in ultra-processed foods and low in fiber, was associated with atherogenic dyslipidemia and the formation of high-risk coronary plaques. A marked synergistic effect between smoking and an inadequate diet was found, producing a double endothelial and metabolic hit that increases the prevalence of a positive coronary artery calcium (CAC) score and advances functional vascular age by up to two decades relative to chronological age. It was concluded that the early interaction between tobacco consumption and a Western diet decisively accelerates vascular aging, reinforcing the urgency of cardiovascular risk stratification by vascular age and the implementation of primary prevention strategies in young adults.