Associations of smoking, alcohol and physical activity with risk factors for coronary heart disease and diabetes risk in the first follow‐up cohort of the Heart Disease and Diabetes Risk Indicators in a Screened Cohort study (HDDRISC‐1)

Abstract

Godsland IF, . Associations of smoking, alcohol and physical activity with risk factors for coronary heart disease and diabetes in the first follow-up cohort of the Heart Disease and Diabetes Risk Indicators in a Screened Cohort study. J Intern Med 1998; 244: 33-41.Objectives. To investigate the associations between risk factors for cardiovascular disease and cigarette smoking, alcohol intake, and physical activity in a group of predominantly healthy men. Design. Cohort study with baseline characterisation, clinical follow-up, and identification of predictors of coronary artery disease and diabetes. Setting. University hospital metabolic day ward. Subjects. Participants in a company health programme (n = 742). Main outcome measures. Routine haematology and biochemistry, cholesterol, triglycerides, high density lipoprotein (HDL) cholesterol (on a subset of 522 subjects), and glucose and insulin levels during a 3 h oral glucose tolerance test (OGTT). Results. Independent associations with previous cigarette smoking included high uric acid and low HDL cholesterol, and with current cigarette smoking, high haemoglobin and white cell count and low OGTT insulin. Increasing alcohol intake was associated with increasing blood pressure, uric acid, HDL cholesterol and fasting glucose. The moderate range of exercise intensity in this cohort was associated with decreasing systolic blood pressure, fasting insulin and OGTT glucose and insulin. Factor analysis distinguished principal factors comprising features of the metabolic syndrome with low physical activity, and high white cell count, high haemoglobin concentration and low HDL cholesterol with increasing previous and current cigarette smoking and alcohol intake. Conclusions. Some characteristics of the metabolic syndrome were seen with previous but not current smoking habit. Regular alcohol consumption was associated with mainly unfavourable metabolic characteristics, although there was an independent beneficial association with HDL cholesterol. The improved metabolic syndrome profile seen with increasing exercise is consistent with even moderate degrees of physical activity having beneficial effects on metabolism.

Lung Disease and Hypertension

“…An association between increased parameters of inflammation and sympathetic overactivity was reported in both a healthy young population [14] and an elderly population without heart disease [15]. An animal study revealed that parasympathetic nervous system activity may have anti-inflammatory effects [16].…”

“…Both COPD and chronic lung disease are associated with sympathetic nervous system activation (fig. 2) due to systemic inflammation [14,15,16], hypoxia [29], lower baroreflex sensitivity [37], inhibition of pulmonary stretch receptors [38], and elevated muscle sympathetic nerve activity [39]. Vascular stiffness was also reported to be elevated in COPD patients [37,40], and the lower baroreflex sensitivity due to vascular stiffness [37] may also result in augmented sympathetic nerve activity.…”

Development healthcare PC and multimedia software for improvement of health status and exercise habits

“…However, a characteristic of such diseases is that they can primarily be alleviated by lifestyle improvements [2,3,8,13,14,19,27,41,55]. The preventive management of metabolic syndromes presented by the third cholesterol management guidelines of the US [39], which defined metabolic syndromes and suggested clinical guidelines, emphasizes that strong lifestyle improvements will act as prevention and management strategies for primary and secondary diseases.…”

Risk indicators of metabolic syndrome in young adults: A preliminary investigation on the influence of tobacco smoke exposure and gender

“…Some studies report individuals who smoke demonstrate reduced insulin sensitivity compared with nonsmokers, 31,[38][39][40][41] whereas others report that current smoking is not associated with decreased insulin sensitivity, and, in some studies, may actually improve insulin sensitivity. 24,[42][43][44][45] Finally, although a large volume of research suggests that CRP is elevated in long-term smokers, 46-51 the mechanism of this effect is unclear. Unclear also is the effect of tobacco smoke exposure on inflammatory cytokines, with reports suggesting both an increase 48,52 and a decrease [53][54][55] in cytokines with smoking.…”

“…57 A smoking history of at least 20 years carries with it the significant likelihood of established morbidity that may independently contribute to both inflammation and to the diagnosis of metabolic syndrome. 42,46,49 Metabolic syndrome is the outcome of many years of accumulating health risks. Although the characteristics of established disease are well recognized, the path of progression from health to disease, taken by young, generally healthy individuals exposed to varying risk factors, is unclear.…”