Cigarette smoking and progression of atherosclerosis - The atherosclerosis risk in communities (ARIC) study
Cigarette smoking and progression of atherosclerosis - The atherosclerosis risk in communities (ARIC) study
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DOI：
10.1001/jama.279.2.119
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发表时间：
1998-01-14
影响因子：
120.7
通讯作者：
Tell, GS
中科院分区：
文献类型：
--
作者：
Howard, G;Wagenknecht, LE;Tell, GS
背景。-吸烟是心脏病和中风的一个强大的风险因素，但主动吸烟和被动吸烟与动脉粥样硬化进展的关系尚未得到描述。目的：检查主动吸烟和暴露于环境烟草烟雾(ETS)对动脉粥样硬化进展的影响。设计：对初次访问时评估的吸烟暴露与动脉粥样硬化3年变化之间的关系进行纵向评估。背景-来自美国4个社区的中年人的人群队列。参与者。-1987年至1989年期间登记的社区动脉粥样硬化风险研究的10914名参与者。主要结果衡量标准。在从基线到5年随访的动脉粥样硬化中，以超声评估的颈动脉内中膜厚度为指标，并根据人口统计学特征进行调整，心血管危险因素和生活方式变量。结果：暴露在香烟烟雾中与动脉粥样硬化的进展有关。相对于从不吸烟者，在调整了人口学特征、心血管危险因素和生活方式变量后，当前吸烟与动脉粥样硬化进展相关50%(3年平均进展率，现吸烟者为43.0微米，从不吸烟者为28.7微米，不考虑ETS暴露)，既往吸烟者与25%的进展率(3年平均进展率，既往吸烟者为35.8微米，从不吸烟者为28.7微米)相关。与未接触ETS的人群相比，暴露于ETS的人群增加了20%(接触ETS的人群为35.2亩，未接触ETS的人群为29.3亩)。吸烟对糖尿病和高血压患者动脉粥样硬化进展的影响更大。尽管暴露年限越长，进展越快(P
Context.-Cigarette smoking is a powerful risk factor for incident heart disease and stroke, but the relationship of active and passive smoking with the progression of atherosclerosis has not been described.Objective.-To examine the impact of active smoking and exposure to environmental tobacco smoke (ETS) on the progression of atherosclerosis.Design.-A longitudinal assessment of the relationship between smoking exposure evaluated at the initial visit and the 3-year change in atherosclerosis.Setting.-A population-based cohort of middle-aged adults from 4 communities in the United States.Participants.-A total of 10914 participants from the Atherosclerosis Risk in Communities (ARIC) study enrolled between 1987 and 1989.Main Outcome Measure.-Change in atherosclerosis from baseline to the 5-year follow-up as indexed by intimal-medial thickness of the carotid artery assessed by ultrasound and adjusted for demographic characteristics, cardiovascular risk factors, and lifestyle variables.Results.-Exposure to cigarette smoke was associated with progression of atherosclerosis. Relative to never smokers and after adjustment for demographic characteristics, cardiovascular risk factors, and lifestyle variables, current cigarette smoking was associated with a 50% increase in the progression of atherosclerosis (mean progression rate over 3 years, 43.0 mu m for current and 28.7 mu m for never smokers, regardless of ETS exposure), and past smoking was associated with a 25% increase (mean progression rate over 3 years, 35.8 mu m for past smokers and 28.7 mu m for never smokers). Relative to those not exposed to ETS, exposure to ETS was associated with a 20% increase (35.2 mu m for those exposed to ETS vs 29.3 mu m for those not exposed). The impact of smoking on atherosclerosis progression was greater for subjects with diabetes and hypertension. Although more pack-years of exposure was independently associated with faster progression (P