Passive smoking and the risk of coronary heart disease a meta-analysis of epidemiologic studies
Passive smoking and the risk of coronary heart disease a meta-analysis of epidemiologic studies
复制标题
DOI：
10.1056/nejm199903253401204
复制
发表时间：
1999-03-25
影响因子：
158.5
通讯作者：
Whelton, PK
中科院分区：
文献类型：
--
作者：
He, J;Vupputuri, S;Whelton, PK
背景被动吸烟对冠心病风险的影响是有争议的。我们对非吸烟者与被动吸烟相关的冠心病风险进行了荟萃分析。方法我们搜索Medline和学位论文摘要在线数据库，并回顾相关文章中的引文，以确定符合预先设定的纳入标准的18项流行病学研究(10个队列和8个病例对照)。研究设计、研究对象的特征、暴露和结果测量、潜在混杂因素的控制和风险估计由三名研究人员使用标准化方案独立提取。结果总的来说，与不吸烟的人相比，暴露在环境烟雾中的非吸烟者患冠心病的相对风险为1.25(95%可信区间，1.17到1.32)。在队列研究(相对风险，1.21；95%可信区间，1.14至1.30)、病例对照研究(相对风险，1.51；95%可信区间，1.26至1.81)、男性(相对风险，1.22；95%可信区间，1.10至1.35)、女性(相对风险，1.24；95%可信区间，1.15至1.34)以及那些在家吸烟的人(相对风险，1.17；在工作场所(相对风险为1.11；95%可信区间为1.00至1.23)。非吸烟者与非吸烟者相比，每日吸烟1~19支和每天吸烟20支或以上的相对危险度分别为1.2 3和1.3 1(线性趋势P=0.006)。结论被动吸烟与冠心病的危险性略有增加。鉴于吸烟的高流行率，被动吸烟对冠心病的公共健康影响可能是重要的。(N Engl J Med 1999；340：920-6)(C)1999年，马萨诸塞州医学会。
Background The effect of passive smoking on the risk of coronary heart disease is controversial. We conducted a meta-analysis of the risk of coronary heart disease associated with passive smoking among nonsmokers.Methods We searched the Medline and Dissertation Abstracts Online data bases and reviewed citations in relevant articles to identify 18 epidemiologic (10 cohort and 8 case-control) studies that met pre-stated inclusion criteria. Information on the designs of the studies, the characteristics of the study subjects, exposure and outcome measures, control for potential confounding factors, and risk estimates was abstracted independently by three investigators using a standardized protocol.Results Overall, nonsmokers exposed to environmental smoke had a relative risk of coronary heart disease of 1.25 (95 percent confidence interval, 1.17 to 1.32) as compared with nonsmokers not exposed to smoke. Passive smoking was consistently associated with an increased relative risk of coronary heart disease in cohort studies (relative risk, 1.21; 95 percent confidence interval, 1.14 to 1.30), in case-control studies (relative risk, 1.51; 95 percent confidence interval, 1.26 to 1.81), in men (relative risk, 1.22; 95 percent confidence interval, 1.10 to 1.35), in women (relative risk, 1.24; 95 percent confidence interval, 1.15 to 1.34), and in those exposed to smoking at home (relative risk, 1.17; 95 percent confidence interval, 1.11 to 1.24) or in the workplace (relative risk, 1.11; 95 percent confidence interval, 1.00 to 1.23). A significant dose-response relation was identified, with respective relative risks of 1.23 and 1.31 for nonsmokers who were exposed to the smoke of 1 to 19 cigarettes per day and those who were exposed to the smoke of 20 or more cigarettes per day, as compared with nonsmokers not exposed to smoke (P=0.006 for linear trend).Conclusions Passive smoking is associated with a small increase in the risk of coronary heart disease. Given the high prevalence of cigarette smoking, the public health consequences of passive smoking with regard to coronary heart disease may be important. (N Engl J Med 1999;340:920-6.) (C) 1999, Massachusetts Medical Society.