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Combined with an influx of national-brand, untaxed cigarettes coming up from southern states, New York City is being flooded with illegal product, they say

Long-term hypertension, diastolic dysfunction, increased cardiac after-load, myocardial fibrosis, alterations in coronary flow reserve, and ultimately left ventricular hypertrophy can result from endothelial failure besides vasoconstrictors up-regulation passageways (183)