Impact of secondhand smoke exposure in former smokers on their subsequent risk of coronary heart disease: evidence from the population-based cohort of the Tehran Lipid and Glucose Study

Sadeghi, Masoumeh; Daneshpour, Maryam Sadat; Khodakarim, Soheila; Momenan, Amir Abbas; Akbarzadeh, Mahdi; Soori, Hamid

doi:10.4178/epih.e2020009

Cited by 10 publications

(7 citation statements)

References 42 publications

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“…First, smoking prevention should remain a high priority at any age. Heart disease caused by smoking also occurs in older adults who had quit smoking and those who were exposed to secondhand smoke, which was consistent with previous studies ( 25 , 26 ). The incidence of heart disease was high in female smokers, and hence the burden of disease is much larger than that in the male population.…”

Section: Discussionsupporting

confidence: 92%

Association between tobacco smoking and heart disease in older adults: a cross-sectional study based on the Chinese Longitudinal Healthy Longevity Survey

Liu¹,

Zheng²,

He³

2023

Ann Transl Med

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Background The association between the risk of heart disease and tobacco smoking has been studied in previous work, but there are arguments among various population. We aimed to investigate the association between heart disease incidence and smoking status among older adults. Methods A cross-sectional analysis was conducted with 10,891 older adults in the 2 most recent waves of the Chinese Longitudinal Healthy Longevity Survey (CLHLS), 2011–2014 and 2014–2018. The data included individual weighting variables to ensure they were nationally representative. The parameters consisted of age, sex, body mass index (BMI), smoking status, and disease history was collected. Smoking measures included current/former/never status, pack-years and the time to first cigarette. Heart disease included coronary artery disease, arrhythmias, heart failure, valve diseases and other heart conditions. Respondents with missed values were excluded. Multivariable logistic regression analyses were performed. Results Among the 10,006 respondents included in the analyses, 4,501 (44.9%) were men. The median age was 88 years old [interquartile range (IQR), 78–96]. A total of 6,713 respondents (67.1%) were nonsmokers, 1,695 respondents (16.9%) were former smokers, and 1,598 respondents (16.0%) were current smokers. The incidence of heart disease was significantly higher in smokers compared with nonsmokers (14.5% vs. 12.8%, P=0.018). Female smokers and those over 80 years old had higher morbidity than male smokers. After adjusting for sex, age, BMI, hypertension, diabetes, area of residency, alcohol status, and exercise status, smokers still had an increased risk of heart disease [odds ratio (OR) 1.29, 95% confidential interval (CI): 1.10–1.50, P=0.001]. The incidence of heart disease also increased with higher intensity of smoking for each additional pack-year (OR 1.01, 95% CI: 1.00–1.02, P=0.011). Conclusions For elderly adults, current or former smoking was largely associated with heart disease incidence, especially in females and those over 80 years old. These variables could be considered for inclusion in future heart disease risk prediction models.

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Section: Discussionsupporting

confidence: 92%

Association between tobacco smoking and heart disease in older adults: a cross-sectional study based on the Chinese Longitudinal Healthy Longevity Survey

Liu¹,

Zheng²,

He³

2023

Ann Transl Med

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“…Considering the above, estimating the burden of smoking in a population can be challenging as smoking exposure can be quantified by various indicators 7 , 10 , 18 , 19 . Length of smoking and pack-years are well-established measures associated with the incidence and severity of tobacco-related diseases 9 , 20 , 21 .…”

Section: Introductionmentioning

confidence: 99%

Burden of current and past smoking across 28 European countries in 2017: A cross-sectional analysis

Teshima¹,

Filippidis²

2022

Tob. Induc. Dis.

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INTRODUCTION Most studies use the prevalence of current smoking as an indicator to quantify the burden of smoking. However, length and intensity of smoking, as well as time since cessation for former smokers are also known to impact smoking-related health risks. The aim of this study was to quantify and compare the burden of smoking across the European Union (EU) using a range of smoking burden indicators. METHODS We conducted a cross-sectional analysis using data from the March 2017 Eurobarometer 87.1 (n=27901, people aged ≥15 years) in 28 European Union Member States (EU MS) and the Tobacco Control Scale. We defined five indicators of smoking burden including the prevalence of current and ever smoking, length of smoking, pack-years, and discounted pack-years, and ranked EU MS by each indicator. Two-level linear and logistic regressions were performed to assess the association between these indicators and sociodemographic and tobacco policy factors. RESULTS Wide variations across the EU countries were observed in all smoking burden indicators. While some MS ranked consistently high (e.g. Greece, France) or consistently low (e.g. Ireland, United Kingdom) in all indicators, we found substantial discrepancies in ranking depending on the indicator used for MS such as Malta, Denmark, Finland and the Netherlands. All indicators of smoking burden were lower among women and respondents without financial difficulties; however, the magnitude of those inequalities varied two-fold among the different indicators. CONCLUSIONS Using a range of smoking burden indicators can be more informative than relying on prevalence alone. Our analysis highlights the limitations of relying solely on prevalence of current smoking to estimate the burden of smoking and the potential value of more nuanced indicators. We recommend that multiple and more nuanced indicators that consider former smokers, intensity and duration of smoking should be utilized to monitor tobacco use and evaluate tobacco control policies.

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“…The range of nicotine exposure is more detailed in LE8, which can comprehensively reflect the nicotine exposure of patients. It is widely accepted that quitting smoking is associated with significant risk reduction in adverse outcomes among patients with CHD [ 25 ]. Our current study showed that nicotine exposure was associated with a 0.6% increased risk of MACEs (HR= 0.994, [95%CI: 0.99–0.99]; p = 0.025), which implied that nicotine exposure should be continuously monitored in patients with cardiovascular disease.…”

Section: Discussionmentioning

confidence: 99%

Predictive Value of Cardiovascular Health Score for Health Outcomes in Patients with PCI: Comparison between Life’s Simple 7 and Life’s Essential 8

Gao

Ping

et al. 2023

IJERPH

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The American Heart Association recently published an updated algorithm for quantitative assessments of cardiovascular health (CVH) metrics, namely Life’s Essential 8 (LE8). This study aimed to compare the predictive value between Life’s Simple 7 (LS7) and LE8 and predict the likelihood of major adverse cardiac events (MACEs) in patients undergoing percutaneous coronary intervention (PCI) to determine the utility of the LE8 in predicting CVH outcomes. A total of 339 patients with acute coronary syndrome (ACS) who had undergone PCI were enrolled to assess the CVH scores using the LS7 and LE8. Multivariable Cox regression analysis was employed to evaluate the predictive value of the two different CVH scoring systems at 2 years for MACEs. Multivariable Cox regression analysis revealed that both the LS7 and LE8 scores were protective factors for MACEs (HR = 0.857, [95%CI: 0.78–0.94], HR = 0.964, [95%CI: 0.95–0.98]; p < 0.05, respectively). Receiver operator characteristic analysis indicated that the area under the curve (AUC) of LE8 was higher than that of LS7 (AUC: 0.662 vs. 0.615, p < 0.05). Lastly, in the LE8 score, diet, sleep health, serum glucose levels, nicotine exposure, and physical activity were found to be correlated with MACEs (HR = 0.985, 0.988, 0.993, 0.994, 0.994, respectively). Our study established that LE8 is a more reliable assessment system for CVH. This population-based prospective study reports that an unfavorable cardiovascular health profile is associated with MACEs. Future research is warranted to evaluate the effectiveness of optimizing diet, sleep health, serum glucose levels, nicotine exposure, and physical activity in reducing the risk of MACEs. In conclusion, our findings corroborated the predictive value of Life’s Essential 8 and provided further evidence for the association between CVH and the risk of MACEs.

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Impact of secondhand smoke exposure in former smokers on their subsequent risk of coronary heart disease: evidence from the population-based cohort of the Tehran Lipid and Glucose Study

Cited by 10 publications

References 42 publications

Association between tobacco smoking and heart disease in older adults: a cross-sectional study based on the Chinese Longitudinal Healthy Longevity Survey

Association between tobacco smoking and heart disease in older adults: a cross-sectional study based on the Chinese Longitudinal Healthy Longevity Survey

Burden of current and past smoking across 28 European countries in 2017: A cross-sectional analysis

Predictive Value of Cardiovascular Health Score for Health Outcomes in Patients with PCI: Comparison between Life’s Simple 7 and Life’s Essential 8

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