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Impact of smoking and smoking cessation on cardiovascular events and mortality among older adults: meta-analysis of individual participant data from prospective cohort studies of the CHANCES consortium

BMJ (Online), 2015-04, Vol.350 (apr20 2), p.h1551-h1551 [Peer Reviewed Journal]

Mons et al 2015 ;BMJ Publishing Group Ltd 2015 ;Mons et al 2015. ;Copyright BMJ Publishing Group LTD Apr 20, 2015 ;info:eu-repo/semantics/openAccess ;Mons et al 2015 2015 Mons et al ;Wageningen University & Research ;ISSN: 0959-8138 ;ISSN: 1756-1833 ;EISSN: 1756-1833 ;DOI: 10.1136/bmj.h1551 ;PMID: 25896935

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Title:
Impact of smoking and smoking cessation on cardiovascular events and mortality among older adults: meta-analysis of individual participant data from prospective cohort studies of the CHANCES consortium
Author: Mons, Ute ; Müezzinler, Aysel ; Gellert, Carolin ; Schöttker, Ben ; Abnet, Christian C ; Bobak, Martin ; de Groot, Lisette ; Freedman, Neal D ; Jansen, Eugène ; Kee, Frank ; Kromhout, Daan ; Kuulasmaa, Kari ; Laatikainen, Tiina ; O’Doherty, Mark G ; Bueno-de-Mesquita, Bas ; Orfanos, Philippos ; Peters, Annette ; van der Schouw, Yvonne T ; Wilsgaard, Tom ; Wolk, Alicja ; Trichopoulou, Antonia ; Boffetta, Paolo ; Brenner, Hermann
Subjects: Age Factors ; Aged ; Cardiovascular Diseases - mortality ; Cardiovascular Diseases - prevention & control ; cigarette-smoking ; disease ; Europe - epidemiology ; Female ; health ; Health Knowledge, Attitudes, Practice ; Humans ; Incidence ; Male ; Medicin och hälsovetenskap ; Middle Aged ; myocardial-infarction ; North America - epidemiology ; population ; Proportional Hazards Models ; Prospective Studies ; rate advancement periods ; Risk Factors ; Smoking - mortality ; Smoking Cessation ; Smoking Prevention ; stroke ; Stroke - mortality ; Stroke - prevention & control ; united-states ; women
Is Part Of: BMJ (Online), 2015-04, Vol.350 (apr20 2), p.h1551-h1551
Description: Objective To investigate the impact of smoking and smoking cessation on cardiovascular mortality, acute coronary events, and stroke events in people aged 60 and older, and to calculate and report risk advancement periods for cardiovascular mortality in addition to traditional epidemiological relative risk measures.Design Individual participant meta-analysis using data from 25 cohorts participating in the CHANCES consortium. Data were harmonised, analysed separately employing Cox proportional hazard regression models, and combined by meta-analysis.Results Overall, 503 905 participants aged 60 and older were included in this study, of whom 37 952 died from cardiovascular disease. Random effects meta-analysis of the association of smoking status with cardiovascular mortality yielded a summary hazard ratio of 2.07 (95% CI 1.82 to 2.36) for current smokers and 1.37 (1.25 to 1.49) for former smokers compared with never smokers. Corresponding summary estimates for risk advancement periods were 5.50 years (4.25 to 6.75) for current smokers and 2.16 years (1.38 to 2.39) for former smokers. The excess risk in smokers increased with cigarette consumption in a dose-response manner, and decreased continuously with time since smoking cessation in former smokers. Relative risk estimates for acute coronary events and for stroke events were somewhat lower than for cardiovascular mortality, but patterns were similar.Conclusions Our study corroborates and expands evidence from previous studies in showing that smoking is a strong independent risk factor of cardiovascular events and mortality even at older age, advancing cardiovascular mortality by more than five years, and demonstrating that smoking cessation in these age groups is still beneficial in reducing the excess risk.
Publisher: England: British Medical Journal Publishing Group
Language: English
Identifier: ISSN: 0959-8138
ISSN: 1756-1833
EISSN: 1756-1833
DOI: 10.1136/bmj.h1551
PMID: 25896935
Source: BMJ Open Access Journals
MEDLINE
NORA Norwegian Open Research Archives
SWEPUB Freely available online
ProQuest Central

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Impact of smoking and smoking cessation on cardiovascular events and mortality among older adults: meta-analysis of individual participant data from prospective cohort studies of the CHANCES consortium

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