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Vicious and detrimental cycle of CS-induced cardiovascular injury. In addition to exogenous ROS delivery, chronic smoking exposure attenuates antioxidant defenses and increases endogenous ROS formation. Oxidative stress (R) will eventually trigger an inflammatory response (I) and metabolic impairment (M) and subsequent cell death (D) that fuel ROS formation. This chronic phenomenon could lead to CVD. The presence of CVD exacerbates CS-mediated RMID process detrimental effects.
