Impact of cigarette smoking on the relationship between body mass index and coronary heart disease: a pooled analysis of 3264 stroke and 2706 CHD events in 378579 individuals in the Asia Pacific region

January 2009
BMC Public Health;2009, Vol. 9 Issue 1, p294
Academic Journal
Background: Elevated levels of body mass index (BMI) and smoking are well established lifestyle risk factors for coronary heart disease (CHD) and stroke. If these two risk factors have a synergistic relationship, rigorous lifestyle modification may contribute to greater reduction in cardiovascular burden than previously expected. Methods: A pooled analysis of individual participant data from 38 cohorts, involving 378,579 participants. Hazards ratios (HRs) and 95% confidence intervals (CIs) for BMI by cigarette smoking status were estimated using Cox proportional hazard models. Results: During a mean follow-up of 3.8 years, 2706 CHD and 3264 strokes were recorded. There was a log-linear, positive relationship of BMI with CHD and stroke in both smokers and nonsmokers with evidence of a synergistic effect of smoking on the association between BMI and CHD only: HRs (95% CIs) associated with a 2 kg/m² higher BMI were 1.13 (1.10 - 1.17) in current smokers and 1.09 (1.06 - 1.11) in non-smokers (p-value for interaction = 0.04). Conclusion: Smoking amplifies the positive association between BMI and CHD but not stroke. If confirmed, these results suggest that effective strategies that target smoking cessation and weight loss are likely to have a greater impact than anticipated on reducing the burden of CHD.


Related Articles

  • Gender Effects on Acute Heart Failure. Blum, Arnon; Sirchan, Rizak; Keinan-Boker, Lital // International Journal of Clinical Medicine;Jul2011, Vol. 2 Issue 3, p254 

    Background: congestive heart failure is the leading cause of hospitalization in the elderly. Little is known about gender effect on baseline characteristics and in-hospital outcome in patients admitted with acute heart failure. Our purpose was to study the gender effect on in-hospital mortality...

  • Smoking induced atherosclerosis in cancers. Helvaci, Mehmet Rami; Aydin, Yusuf; Gundogdu, Mehmet // HealthMed;2012, Vol. 6 Issue 11, p3744 

    Background: Strong associations between smoking and systemic atherosclerosis and cancers are well documented. Methods: Consecutive female and males with coronary heart disease (CHD) were studied. Results: Study included 1,620 females and 1,240 males. Prevalences of CHD were similar in both sexes...

  • Results and cost of meeting the National Service Framework for Coronary Heart Disease requirement for 12 month follow‐up after acute coronary events. Evans, Julie; Turner, Sally; Bethell, Hugh // Journal of Public Health;Jun2004, Vol. 26 Issue 2, p185 

    Background The National Service Framework (NSF) for Coronary Heart Disease (CHD) set standards, targets and milestones. In the case of acute myocardial infarction (AMI) or coronary revascularization, Milestone 3 of Standard 12 requires a 12 month audit of exercise and smoking habit and of body...

  • Learning from anomalies: the case of cholesterol and ischaemic heart disease. Schooling, C. Mary; Leung, Gabriel M. // International Journal of Epidemiology;Feb2016, Vol. 45 Issue 1, p290 

    No abstract available.

  • Body mass index in late adolescence and its association with coronary heart disease and stroke in middle age among Swedish men. Falkstedt, D.; Hemmingsson, T.; Rasmussen, F.; Lundberg, I. // International Journal of Obesity;May2007, Vol. 31 Issue 5, p777 

    Background and objectives:Body mass index (BMI) in adolescence may be of particular importance as a predictor of future risk of coronary heart disease (CHD). Associations measured either in childhood or in middle age have appeared to be weaker or non-existent. We investigated the association...

  • Higher body mass index at the time of acute myocardial infarction is associated with a favorable long-term prognosis (8-year follow-up). Ikeda, Nobutaka; Nakajima, Rintaro; Utsunomiya, Makoto; Hori, Masaki; Itaya, Hideki; Makino, Kunihiko; Ono, Tsuyoshi; Yamamoto, Masaya; Nemoto, Naohiko; Iijima, Raisuke; Hara, Hidehiko; Takagi, Takuro; Hara, Hisao; Nakamura, Masato; Sugi, Kaoru // Heart & Vessels;Sep2011, Vol. 26 Issue 5, p495 

    Obesity is an important public health problem, especially among patients with cardiovascular disease. However, little is known about the impact of obesity on the long-term prognoses of patients with acute myocardial infarction (AMI). Major adverse cardiac and cerebrovascular events (MACCE)...

  • Road traffic noise, air pollution components and cardiovascular events. de Kluizenaar, Yvonne; van Lenthe, Frank J.; Visschedijk, Antoon J. H.; Zandveld, Peter Y. J.; Miedema, Henk M. E.; Mackenbach, Johan P. // Noise & Health;Nov/Dec2013, Vol. 15 Issue 67, p388 

    Traffic noise and air pollution have been associated with cardiovascular health effects. Until date, only a limited amount of prospective epidemiological studies is available on long-term effects of road traffic noise and combustion related air pollution. This study investigates the relationship...

  • Epidemiology of Cardiovascular Mortality and Risk Factors in the Asia Pacific Region. Geok Lin Khor // Asia Pacific Journal of Clinical Nutrition;2002 Supplement, Vol. 11, pS37 

    Cardiovascular disease (CVD) embraces the conditions of the heart, hypertension and conditions of the cerebral, carotid and peripheral circulation. In terms of its effects on disability and mortality, CVD accounts for almost 10% of the global burden of disease. The two principal forms of CVD,...

  • Relationship of Microalbuminuria with Ischaemic Heart Disease in Non-Diabetic Subjects. Sapna; Singh, Jaswant; Singh, Tarsempal; Mahajan, Mridula; Verma, Nikhil; Garg, Parveen // Indian Journal of Public Health Research & Development;Oct-Dec2015, Vol. 6 Issue 4, p119 

    Ischaemic heart disease is the leading cause of morbidity and mortality world-wide. There are various classical risk factors for Ischaemic heart disease like age, gender, diabetes, hypertension, smoking, increased BMI and abnormal lipid profiles. To reduce the burden of Ischaemic heart disease,...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics