TY - JOUR
T1 - Smoking and atherosclerotic cardiovascular disease in women with lower levels of serum cholesterol
AU - Jee, Sun Ha
AU - Park, Jungyong
AU - Jo, Inho
AU - Lee, Jakyoung
AU - Yun, Soojin
AU - Yun, Ji Eun
AU - Jang, Yangsu
N1 - Funding Information:
The authors thank the staff of the Korean National Insurance Corporation. This study was partially supported by a grant of Ministry of Health and Welfare, Republic of Korea (00-PJ6-PG5-23-0001) and Seoul City R&BD project.
PY - 2007/2
Y1 - 2007/2
N2 - 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.
AB - 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.
KW - Cardiovascular disease
KW - Low serum cholesterol
KW - Smoking
UR - http://www.scopus.com/inward/record.url?scp=33846082300&partnerID=8YFLogxK
U2 - 10.1016/j.atherosclerosis.2006.03.023
DO - 10.1016/j.atherosclerosis.2006.03.023
M3 - Article
C2 - 16677653
AN - SCOPUS:33846082300
SN - 0021-9150
VL - 190
SP - 306
EP - 312
JO - Atherosclerosis
JF - Atherosclerosis
IS - 2
ER -