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, 19 (1), 1042

Smoking Habits and Incidence of Cardiovascular Diseases in Men and Women: Findings of a 12 Year Follow Up Among an Urban Eastern-Mediterranean Population

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Smoking Habits and Incidence of Cardiovascular Diseases in Men and Women: Findings of a 12 Year Follow Up Among an Urban Eastern-Mediterranean Population

Parisa Amiri et al. BMC Public Health.

Abstract

Background: Despite the strong association of smoking with cardiovascular disease (CVD) and cerebral stroke, the consequences of smoking have not been elucidated among Iranian populations. This study aimed to assess sex-specific incidence of CVDs among an urban Iranian population with different smoking habits.

Methods: Participants were recruited from the Tehran Lipid and Glucose Study (TLGS). Data on socio-demographic features and smoking habits from a sample of 10,400 individuals (4378 men and 6022 women), aged ≥20 years without prior CVD history were analyzed. Participants were followed up for 12 years for incidence of CVD/CHD events. Men were categorized in six groups, including never-, passive, ex-, passive and ex-, occasional and daily smokers. Women were categorized in three groups, i.e. never smokers, passive smokers and ever smokers. Using cox regression model, adjusted hazard ratios (HRs) of incident CVD/CHD were calculated for each group, given never smokers as the reference.

Results: In men, HR of CVD was 1.13 (95%CI: 0.80-1.59) in passive smokers, 1.23 (95%CI: 0.91-1.66) in ex-smokers, 1.46 (95%CI: 0.90-2.36) in passive and ex-smokers, 2.33 (95%CI: 1.25-4.33) in occasional smokers and 2.05 (95%CI: 1.57-2.67) in daily smokers. In smokers of ≥21 cigarettes/day, HR of CVD was 3.79 (95%CI: 2.25-6.37), with less risk observed in those who smoked lesser numbers of cigarettes/day. Quitters of ≥15 years were almost risk free. In women, none of the HRs of CVD/CHD were significant.

Conclusion: An increased risk of incidence of CVD/CHD was found in current male smokers. To confirm and further elaborate these findings, more data of sex-specific studies are required from culturally diverse urban and rural areas of Iran.

Keywords: Cardio-vascular outcomes; Iran; Smoking habits; TLGS.

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Flow diagram of participants recruitment. Dashed boxes represent exclusion. CVD. Cardiovascular diseases
Fig. 2
Fig. 2
Hazard ratios and 95% confidence intervals (CI) for CVD/CHD incidence in men, among different smoking groups (Ref: never smoker). Tehran Lipid and Glucose study 1999–2010. Model 1. Adjusted for age. Model 2. Adjusted for age and cardio-metabolic risk factors including: body mass index, systolic blood pressure, diastolic blood pressure, triglyceride levels, cholesterol level and fasting blood sugar. Model 3. Adjusted for age, cardio-metabolic risk factors (as above) and socio-economic features including: education (Ref: college degree), marital status (Ref: married) and occupation (Ref: employed). P. Passive smoker; Ex. Ex-smoker; P.Ex. Passive and Ex-smoker; O. Occasional smoker; D. Daily smoker
Fig. 3
Fig. 3
Hazard ratios and 95% confidence intervals (CI) for CVD incidence in male smokers and ex-smokers, based on the number of cigarettes smoked per day, or the time spent since the last quit, respectively (ref: never smoker). Model 1. Adjusted for age. Model 2. Adjusted for age and cardio-metabolic risk factors including: body mass index, systolic blood pressure, diastolic blood pressure, triglycerides level, cholesterol level and fasting blood sugar. Model 3. Adjusted for age, cardio-metabolic risk factors (as above) and socio-economic features including: education (Ref: college degree), marital status (Ref: married) and occupation (Ref: employed). Q ≥ 15y, Quit 15 years ago or before; Q < 15y, Quit in the last 15 years; ≤ 10 c/day, Smoking ≤10 cigarettes/day; 11–20 c/day, Smoking 11–20 cigarettes/day; ≥ 21 c/day, Smoking ≥21 cigarettes/day
Fig. 4
Fig. 4
Hazard ratios and 95% confidence intervals (CI) for CVD/CHD incidence in women, among different smoking groups (Ref: never smoker). Tehran Lipid and Glucose study 1999–2010. Model 1. Adjusted for age. Model 2. Adjusted for age and cardio-metabolic risk factors including: body mass index, systolic blood pressure, diastolic blood pressure, triglycerides level, cholesterol level and fasting blood sugar. Model 3. Adjusted for age, cardio-metabolic risk factors (as above) and socio-economic features including: education (Ref: college degree), marital status (Ref: married) and occupation (Ref: employed)

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References

    1. Kendir C, van den Akker M, Vos R, Metsemakers J. Cardiovascular disease patients have increased risk for comorbidity: a cross-sectional study in the Netherlands. Eur J Gen Pract. 2018;24:45–50. doi: 10.1080/13814788.2017.1398318. - DOI - PMC - PubMed
    1. Turk-Adawi K, et al. Cardiovascular disease in the eastern Mediterranean region: epidemiology and risk factor burden. Nat Rev Cardiol. 2018;15:106. doi: 10.1038/nrcardio.2017.138. - DOI - PubMed
    1. Roth GA, et al. Global, regional, and national burden of cardiovascular diseases for 10 causes, 1990 to 2015. J Am Coll Cardiol. 2017;70:1–25. doi: 10.1016/j.jacc.2017.04.052. - DOI - PMC - PubMed
    1. Forouzanfar MH, et al. Evaluating causes of death and morbidity in Iran, global burden of diseases, injuries, and risk factors study 2010. Arch Iran Med. 2014;17:304. - PubMed
    1. Teo K, et al. Prevalence of a healthy lifestyle among individuals with cardiovascular disease in high-, middle- and low-income countries: the prospective urban rural epidemiology (PURE) study. Jama. 2013;309:1613–1621. doi: 10.1001/jama.2013.3519. - DOI - PubMed

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