Smoking and atherosclerotic cardiovascular disease in women with lower levels of serum cholesterol
Smoking and atherosclerotic cardiovascular disease in women with lower levels of serum cholesterol
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DOI：
10.1016/j.atherosclerosis.2006.03.023
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发表时间：
2007-02-01
期刊：
影响因子：
5.3
通讯作者：
Jang, Yangsu
中科院分区：
文献类型：
--
作者：
Jee, Sun Ha;Park, Jungyong;Jang, Yangsu
这项对韩国人的队列研究调查了吸烟与动脉粥样硬化性心血管疾病（ASCVD）之间的关系，以及血清总胆固醇水平是否改变了吸烟对ASCVD的影响。对234，399名韩国妇女进行了一项为期10年的前瞻性队列研究，年龄在40-69岁之间，从国家健康保险公司获得健康保险，并于1993年进行了医疗评估。主要结果指标为缺血性心脏病（IHD）、脑血管病（CVD）和总ASCVD的住院率和死亡率。基线时，13，696例（5.8%）目前吸烟，105，755例（45.1%）总胆固醇< 200 mg/dl。1994年至2003年，发生了4534例IHD（176/100，000人年），7961例CVD（310/100，000人年）和2418例其他ASCVD事件（94/100，000人年）。在控制年龄、高血压、高胆固醇血症、糖尿病和饮酒的多变量考克斯比例风险模型中，目前吸烟增加了IHD的风险[风险比（HR）= 1.7（95% CI：1.5-1.9）]、CVD [HR = 1.6（95% CI：1.5-1.6）]和总ASCVD事件[HR = 1.6（95% CI：1.5-1.7）]。在整个血清胆固醇水平范围内，目前吸烟显著增加心肌梗死和心血管疾病的风险，但不增加心绞痛的风险。没有证据表明吸烟与血清胆固醇之间存在相互作用（IHD、CVD和总ASCVD的相互作用P分别为0.469、0.612和0.905）。低胆固醇水平对吸烟相关的ASCVD没有保护作用。(c)2006爱思唯尔爱尔兰有限公司保留所有权利。
This cohort study of Koreans examines the relationship between smoking on atherosclerotic cardiovascular disease (ASCVD) and whether serum levels of total cholesterol modify the impact of smoking on ASCVD.A 10-year prospective cohort study was carried out on 234,399 Korean women, ranging 40-69 years of age who received health insurance from the National Health Insurance Corporation and had a medical evaluation in 1993. The main outcome measures were hospital admissions and deaths from ischemic heart disease (IHD), cerebrovascular disease (CVD), and total ASCVD.At baseline, 13,696 (5.8%) were current smokers and 105,755 (45.1%) had a total cholesterol < 200 mg/dl. Between 1994 and 2003, 4534 IHD (176/100,000 person year), 7961 CVD (310/100,000 person year), and 2418 other ASCVD events (94/100,000 person year) occurred. In multivariate Cox proportional hazard models controlling for age, hypertension, hypercholesterolemia, diabetes and alcohol drinking, current smoking increased the risk of IHD [hazard ratio (HR) = 1.7 (95% CI: 1.5-1.9)], CVD [HR = 1.6 (95% CI: 1.5-1.6)], and total ASCVD events [HR = 1.6 (95% CI: 1.5-1.7)]. Throughout the range of serum cholesterol levels, current smoking significantly increased the risk of myocardial infarction and CVD, but not angina pectoris. There was no evidence of an interaction between smoking and serum cholesterol (P for interaction = 0.469, 0.612, and 0.905 for IHD, CVD, and total ASCVD, respectively).This study demonstrated that smoking was a major independent risk factor for IHD, CVD and ASCVD in Korean women. A low cholesterol level confers no protective benefit against smoking-related ASCVD. (c) 2006 Elsevier Ireland Ltd. All rights reserved.