Smoking, smoking status, and risk for symptomatic peripheral artery disease in women: a cohort study.
Summary of "Smoking, smoking status, and risk for symptomatic peripheral artery disease in women: a cohort study."
Background: Smoking has a well-documented detrimental effect on risk for myocardial infarction and stroke, but less information is available regarding peripheral artery disease (PAD), particularly among women. Objective: To prospectively assess the association of current smoking status, cumulative smoking exposure, and smoking cessation with incident symptomatic PAD in women. Design: Prospective cohort study. Setting: U.S. female health care professionals in the Women's Health Study. Participants: 39 825 women with no cardiovascular disease who were prospectively followed for a median of 12.7 years. Measurements: Incidence of symptomatic PAD. Cox proportional hazards models were used to compare PAD risk across smoking categories. Results: 178 confirmed PAD events occurred. Across the 4 smoking categories (never, former, <15 cigarettes/d, and ≥15 cigarettes/d), age-adjusted incidence rates were 0.12, 0.34, 0.95, and 1.63 per 1000 person-years of follow-up, respectively. Multivariate adjustment had little effect on this relationship (adjusted hazard ratios [HRs], 3.14 [95% CI, 2.01 to 4.90], 8.93 [CI, 5.02 to 15.89], and 16.95 [CI, 10.77 to 26.67], respectively, vs. women who never smoked). Additional adjustment for high-sensitivity C-reactive protein and soluble intercellular adhesion molecule-1 levels among women with available blood samples (28 314 participants, 117 events) attenuated risk estimates (HR, 5.58 [CI, 2.61 to 11.93] for smoking <15 cigarettes/d and 9.52 [CI, 5.17 to 17.53] for smoking ≥15 cigarettes/d). Lifetime exposure showed a strong dose-response relationship; fully adjusted HRs for smoking abstinence of fewer than 10, 10 to 29, and 30 or more pack-years were 2.52 (CI, 1.49 to 4.25), 6.75 (CI, 4.33 to 10.52), and 11.09 (CI, 6.94 to 17.72), respectively. Compared with current smokers, the adjusted HRs for fewer than 10 years, 10 to 20 years, more than 20 years, or lifelong abstinence were 0.39 (CI, 0.24 to 0.66), 0.28 (CI, 0.17 to 0.46), 0.16 (CI, 0.10 to 0.26), and 0.08 (CI, 0.05 to 0.12), respectively. Limitation: The use of symptomatic PAD as the a priori primary end point excludes asymptomatic disease. Conclusion: Among initially healthy women, smoking is a potent risk factor for symptomatic PAD and was associated with subclinical inflammation. Smoking cessation substantially reduces risk for PAD, but an increased occurrence of PAD persists even among former smokers who maintain abstinence. Primary Funding Source: The National Heart, Lung, and Blood Institute and National Cancer Institute.
University Hospital, Basel, Switzerland; Brigham and Women's Hospital, Harvard Medical School, Harvard School of Public Health, and Veterans Affairs Boston Medical Center, Boston, Massachusetts; and INSERM Unit 708-Neuroepidemiology and University Pierre
This article was published in the following journal.
Name: Annals of internal medicine
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/21646555
- DOI: http://dx.doi.org/10.1059/0003-4819-154-11-201106070-00003
Smoking is a major risk factor for heart disease. Over the past decade, the prevalence of smoking and the number of cigarettes smoked per day have decreased in Canada. Using a contemporary cohort of C...
Introduction: While chronic cigarette smoking can lead to increased risk of stroke, the acute effects of smoking have not been established. We studied the changes in blood flow parameters in the major...
Abstract Aim: To examine the association of different smoking groups with cardiovascular disease (CVD), coronary heart diseases (CHD) and CVD attributed death and death due to all causes in a male Teh...
Introduction: Smoking has a negative impact on the outcome of surgical procedures. Smoking leads to higher risk of postoperative complications and it delays wound healing. Materials and methods: We ob...
It is well established that cigarette smoking is hazardous to health and is a risk factor for many chronic diseases. However, its impact on the brain, whether it be from prenatal exposure to maternal...
The researchers hypothesize that smoking cessation counseling improves with the implementation of a smoking status assessment data sheet in routine consults. This is a quality improvement...
Currently one in five high school students smoke. Smoking can harm adolescents well before they reach adulthood by causing a number of immediate, sometimes irreversible, health risks and...
Cigarette smoking increases CVD risk and worsens insulin resistance, but also contributes to weight loss; smoking cessation reduces CVD risk and improves insulin sensitivity, but also cont...
Among veterans, smoking is the single most important risk factor for preventable mortality and morbidity, and studies suggest a higher prevalence of smoking among veterans than the general...
The purpose of this study is to determine if checking smoking status as a routine vital sign increases the delivery rate of cessation counseling to adult smokers in primary care practices.
Medical and Biotech [MESH] Definitions
Discontinuation of the habit of smoking, the inhaling and exhaling of tobacco smoke.
Motivational state produced by inconsistencies between simultaneously held cognitions or between a cognition and behavior; e.g., smoking enjoyment and believing smoking is harmful are dissonant.
Common occlusive arterial disease which is caused by ATHEROSCLEROSIS. It is characterized by lesions in the innermost layer (ARTERIAL INTIMA) of arteries including the AORTA and its branches to the extremities. Risk factors include smoking, HYPERLIPIDEMIA, and HYPERTENSION.
A form of CARDIAC MUSCLE disease that is characterized by ventricular dilation, VENTRICULAR DYSFUNCTION, and HEART FAILURE. Risk factors include SMOKING; ALCOHOL DRINKING; HYPERTENSION; INFECTION; PREGNANCY; and mutations in the LMNA gene encoding LAMIN TYPE A, a NUCLEAR LAMINA protein.
An alkaloid that has actions similar to NICOTINE on nicotinic cholinergic receptors but is less potent. It has been proposed for a variety of therapeutic uses including in respiratory disorders, peripheral vascular disorders, insomnia, and smoking cessation.