3 research outputs found
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
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
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
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