Literature Review: Smoking, obesity, and cardiovascular risk: evidence from recent studies

This literature review examines the independent and combined effects of smoking and obesity on cardiovascular risk, with the aim of synthesizing recent evidence to clarify their roles in the development and progression of cardiovascular disease. The scope of this review covers observational studies, cohort analyses, and selected clinical investigations published in the past decade that evaluate associations between tobacco exposure, excess adiposity, and major cardiovascular outcomes, including coronary heart disease, stroke, and cardiovascular mortality. Across the reviewed studies, smoking consistently emerged as a strong and immediate risk factor through mechanisms involving endothelial dysfunction, inflammation, and thrombogenesis, while obesity contributed through metabolic disturbances such as insulin resistance, dyslipidemia, and chronic low-grade inflammation. Several studies further demonstrated a synergistic effect, in which the coexistence of smoking and obesity conferred a substantially higher cardiovascular risk than either factor alone. The evidence also indicates that smoking may attenuate some apparent protective effects of weight reduction, while obesity may amplify smoking-related vascular damage. In conclusion, recent literature underscores that smoking and obesity are not only independent but also interacting determinants of cardiovascular risk. Effective cardiovascular prevention strategies should therefore address both behaviors simultaneously, rather than in isolation, to achieve meaningful and sustained risk reduction.