Trends of ischemic heart disease mortality attributable to smoking in the five countries with the highest number of smokers during 1990–2019: an age-period-cohort analysis

Abstract

IntroductionSmoking increases the risk of various cardiovascular diseases, including ischemic heart disease (IHD). This study aimed to assess the impact of age, period, and cohort on long-term trends in IHD mortality in China, India, Indonesia, the United States, and Russia, the five countries with the highest number of smokers, from 1990 to 2019.Material and methodsThe data were obtained from the Global Burden of Disease (GBD) Study 2019, and the age-standardized mortality rate (ASMR) was calculated. Joinpoint regression analysis was used to assess the magnitude and direction of trends in smoking-attributable mortality from IHD. Age-period-cohort (APC) studies were used to estimate net drift (estimated annual percentage change (EAPC)s), local drift (age-specific EAPCs), and independent trends in age, period, and cohort effects.ResultsThe analysis revealed a significant downward trend in ASMRs attributable to IHD as a result of smoking in the United States, India, and Russia. Indonesia and China showed an upward trend. Age effects were increasing for both country and sex, with China showing the most significant increase in the older age group; period effects were decreasing in all countries except Indonesia, and cohort effects were increasing only in Indonesia and China.ConclusionsFrom 1990 to 2019, mortality from IHD caused by smoking showed a downward trend in these five countries. However, the pattern of increased mortality from IHD in women caused by smoking warrants further study.

Global, regional, and national burden of ischemic heart disease attributable to secondhand smoke from 1990 to 2019

“…Our research findings underscore the imperative need to reinforce smoking control policies and diminish public exposure to SHS 28 . The comprehensive enforcement of indoor smoking bans and public education campaigns to elevate awareness of the hazards associated with SHS exposure constitutes a pivotal strategy for safeguarding public health and alleviating healthcare burdens 5 , 29 .…”

“…Moreover, fostering smoke-free environments and providing readily accessible smoking cessation support services, such as counseling and nicotine replacement therapies, are crucial for facilitating smokers’ quitting efforts 20 , 30 . This multifaceted approach demands the collaborative involvement of government agencies, community organizations, and the wider public to foster a healthier living environment and reduce the risk of diseases such as IHD 28 , 31 . In our study, we also observed that the decline in mortality rates among men and the older age groups is slower, and there is a continuous increase in the DALYs rates among the elderly population in middle-income countries.…”

Bidirectional Two-Sample Mendelian Randomization Study of Association between Smoking Initiation and Atrial Fibrillation

“…This process is caused by more than 7000 chemicals found in cigarettes, such as tar, nicotine, and carbon monoxide. These chemicals can cause cardiovascular disease by increasing heart rate and myocardial contractility, promoting inflammation, causing endothelial damage and thrombosis, and lowering serum high-density lipoprotein cholesterol levels [18][19][20] . Inflammation plays an Each black point represents an inverse variance weighted method for estimating the effect of smoking initiation on atrial fibrillation, excluding that particular instrumental variable from the analysis.…”