The Concept of CMR

Smoking and Cardiovascular Health

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It is well established that cigarette smoking is one of the most important modifiable risk factors for CHD (3, 5-14). The Centers for Disease Control and Prevention have reported that cigarette smokers are 2 to 4 times more likely to develop CHD than non-smokers (3). Smokers are also more than 10 times more likely to develop peripheral vascular disease than non-smokers. It has been estimated that cigarette smoking approximately doubles a person’s risk for stroke. The pooled relative risk of stroke associated with cigarette smoking was 1.5 in a meta-analysis conducted by Shinton et al. (9). In addition, the Atherosclerosis Risk in Communities (ARIC) Study showed that smoking-related CHD risk was much higher in the presence of higher LDL cholesterol (15). In the INTERHEART study, a myocardial infarction case-control study conducted in 52 countries, current smokers had a greater risk (odds ratio [OR]: 2.95) of acute myocardial infarction (AMI) compared to individuals who had never smoked. By shortening life, smoking decreases CVD probability and duration throughout the life course, though non-smokers live many years longer and are longer free of CVD than smokers (16). The risk associated with cigarette smoking varies with age, gender, ethnicity, amount of cigarettes smoked per day, and other factors. 

Reference

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13. Doll R, Peto R, Wheatley K, et al. Mortality in relation to smoking: 40 years' observations on male British doctors. BMJ 1994; 309: 901-11.

14. Ockene IS and Miller NH. Cigarette smoking, cardiovascular disease, and stroke: a statement for healthcare professionals from the American Heart Association. American Heart Association Task Force on Risk Reduction. Circulation 1997; 96: 3243-7.

15. Hozawa A, Folsom AR, Sharrett AR, et al. Does the impact of smoking on coronary heart disease differ by low-density lipoprotein cholesterol level? the Atherosclerosis Risk in Communities (ARIC) Study. Circ J 2006; 70: 1105-10.

16. Mamun AA, Peeters A, Barendregt J, et al. Smoking decreases the duration of life lived with and without cardiovascular disease: a life course analysis of the Framingham Heart Study. Eur Heart J 2004; 25: 409-15.

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