Smoking and Risk of Coronary Heart Disease in Younger, Middle-aged, and Older Adults

Overview

Journal Am J Public Health

Specialty Public Health

Date 2013 Jun 15

PMID 23763425

Citations 32

Authors

Janne S Tolstrup

Ulla A Hvidtfeldt

Esben Meulengracht Flachs

Donna Spiegelman

Berit L Heitmann

Katarina Balter

Uri Goldbourt

Goran Hallmans

Paul Knekt

Simin Liu

Mark Pereira

June Stevens

Jarmo Virtamo

Diane Feskanich

Affiliations

Soon will be listed here.

Abstract

Objectives: We investigated associations of smoking and coronary heart disease (CHD) by age.

Methods: Data came from the Pooling Project on Diet and Coronary Heart Disease (8 prospective studies, 1974-1996; n = 192,067 women and 74,720 men, aged 40-89 years).

Results: During follow-up, 4326 cases of CHD were reported. Relative to never smokers, CHD risk among current smokers was highest in the youngest and lowest in the oldest participants. For example, among women aged 40 to 49 years the hazard ratio was 8.5 (95% confidence interval [CI] = 5.0, 14) and 3.1 (95% CI = 2.0, 4.9) among those aged 70 years or older. The largest absolute risk differences between current smokers and never smokers were observed among the oldest participants. Finally, the majority of CHD cases among smokers were attributable to smoking. For example, attributable proportions of CHD by age group were 88% (40-49 years), 81% (50-59 years), 71% for (60-69 years), and 68% (≥ 70 years) among women who smoked.

Conclusions: Among smokers, the majority of CHD cases are attributable to smoking in all age groups. Smoking prevention is important, irrespective of age.

Citing Articles

Cardiovascular Effects of Smoking and Smoking Cessation: A 2024 Update.

Rahman M, Alatiqi M, Al Jarallah M, Hussain M, Monayem A, Panduranga P Glob Heart. 2025; 20(1):15.

PMID: 39991592 PMC: 11843939. DOI: 10.5334/gh.1399.

The correlation between cumulative cigarette consumption and infarction-related coronary spasm in patients with ST-segment elevation acute myocardial infarction across different age groups.

Kuang Z, Lin L, Kong R, Wang Z, Mao X, Xiang D Sci Rep. 2025; 15(1):253.

PMID: 39747215 PMC: 11697210. DOI: 10.1038/s41598-024-84125-5.

Estrogen administration enhances the adverse effects of cigarette smoking on the heart in cycling female mice.

Abidi E, Diab R, Zahreddine R, Amin G, Kaplan A, Booz G Biol Sex Differ. 2024; 15(1):100.

PMID: 39633480 PMC: 11616276. DOI: 10.1186/s13293-024-00667-3.

Epidemiological Association of Current Smoking Status with Hypertension and Obesity among Adults Including the Elderly in Korea: Multivariate Analysis of a Nationwide Cross-Sectional Study Excluding Grades 2-3 Hypertension Cases.

Park S, Jang S, So W, Kim J J Cardiovasc Dev Dis. 2024; 11(7).

PMID: 39057632 PMC: 11278024. DOI: 10.3390/jcdd11070212.

Association of lifestyle modification with the development of cardiovascular disease in gastric cancer patients who underwent gastrectomy: A nationwide population-based study.

Kim B, Han K, Cho S Cancer Med. 2024; 13(14):e70038.

PMID: 39046111 PMC: 11267560. DOI: 10.1002/cam4.70038.

References

Hoyer A, Engholm G . Serum lipids and breast cancer risk: a cohort study of 5,207 Danish women. Cancer Causes Control. 1992; 3(5):403-8. DOI: 10.1007/BF00051352. View

Pereira M, OReilly E, Augustsson K, Fraser G, Goldbourt U, Heitmann B . Dietary fiber and risk of coronary heart disease: a pooled analysis of cohort studies. Arch Intern Med. 2004; 164(4):370-6. DOI: 10.1001/archinte.164.4.370. View

Smith-Warner S, Spiegelman D, Ritz J, Albanes D, Beeson W, Bernstein L . Methods for pooling results of epidemiologic studies: the Pooling Project of Prospective Studies of Diet and Cancer. Am J Epidemiol. 2006; 163(11):1053-64. DOI: 10.1093/aje/kwj127. View

Zdravkovic S, Wienke A, Pedersen N, Marenberg M, Yashin A, de Faire U . Heritability of death from coronary heart disease: a 36-year follow-up of 20 966 Swedish twins. J Intern Med. 2002; 252(3):247-54. DOI: 10.1046/j.1365-2796.2002.01029.x. View

Oei H, Vliegenthart R, Hofman A, Oudkerk M, Witteman J . Risk factors for coronary calcification in older subjects. The Rotterdam Coronary Calcification Study. Eur Heart J. 2003; 25(1):48-55. DOI: 10.1016/j.ehj.2003.10.008. View

Rexrode K, Lee I, Cook N, Hennekens C, Buring J . Baseline characteristics of participants in the Women's Health Study. J Womens Health Gend Based Med. 2000; 9(1):19-27. DOI: 10.1089/152460900318911. View

Devore E, Kang J, Okereke O, Grodstein F . Physical activity levels and cognition in women with type 2 diabetes. Am J Epidemiol. 2009; 170(8):1040-7. PMC: 2765365. DOI: 10.1093/aje/kwp224. View

Rimm E, Giovannucci E, Stampfer M, Colditz G, Litin L, Willett W . Reproducibility and validity of an expanded self-administered semiquantitative food frequency questionnaire among male health professionals. Am J Epidemiol. 1992; 135(10):1114-26; discussion 1127-36. DOI: 10.1093/oxfordjournals.aje.a116211. View

. The alpha-tocopherol, beta-carotene lung cancer prevention study: design, methods, participant characteristics, and compliance. The ATBC Cancer Prevention Study Group. Ann Epidemiol. 1994; 4(1):1-10. DOI: 10.1016/1047-2797(94)90036-1. View

10.

Knekt P, Reunanen A, Jarvinen R, Seppanen R, Heliovaara M, Aromaa A . Antioxidant vitamin intake and coronary mortality in a longitudinal population study. Am J Epidemiol. 1994; 139(12):1180-9. DOI: 10.1093/oxfordjournals.aje.a116964. View

11.

Fraser G, Sabate J, Beeson W, Strahan T . A possible protective effect of nut consumption on risk of coronary heart disease. The Adventist Health Study. Arch Intern Med. 1992; 152(7):1416-24. View

12.

Wacholder S, Benichou J, Heineman E, Hartge P, Hoover R . Attributable risk: advantages of a broad definition of exposure. Am J Epidemiol. 1994; 140(4):303-9. DOI: 10.1093/oxfordjournals.aje.a117252. View

13.

Tanasescu M, Leitzmann M, Rimm E, Hu F . Physical activity in relation to cardiovascular disease and total mortality among men with type 2 diabetes. Circulation. 2003; 107(19):2435-9. DOI: 10.1161/01.CIR.0000066906.11109.1F. View

14.

. The Atherosclerosis Risk in Communities (ARIC) Study: design and objectives. The ARIC investigators. Am J Epidemiol. 1989; 129(4):687-702. View

15.

Hemila H, Kaprio J, Albanes D, Virtamo J . Physical activity and the risk of pneumonia in male smokers administered vitamin E and beta-carotene. Int J Sports Med. 2006; 27(4):336-41. DOI: 10.1055/s-2005-865670. View

16.

Proietti R, Mapelli D, Volpe B, Bartoletti S, Sagone A, Dal Bianco L . Mental stress and ischemic heart disease: evolving awareness of a complex association. Future Cardiol. 2011; 7(3):425-37. DOI: 10.2217/fca.11.13. View

17.

Menotti A, Lanti M, Nedeljkovic S, Nissinen A, Kafatos A, Kromhout D . The relationship of age, blood pressure, serum cholesterol and smoking habits with the risk of typical and atypical coronary heart disease death in the European cohorts of the Seven Countries Study. Int J Cardiol. 2005; 106(2):157-63. DOI: 10.1016/j.ijcard.2004.12.092. View

18.

Munger R, Folsom A, Kushi L, Kaye S, Sellers T . Dietary assessment of older Iowa women with a food frequency questionnaire: nutrient intake, reproducibility, and comparison with 24-hour dietary recall interviews. Am J Epidemiol. 1992; 136(2):192-200. DOI: 10.1093/oxfordjournals.aje.a116485. View

19.

Willett W, Sampson L, Stampfer M, Rosner B, Bain C, Witschi J . Reproducibility and validity of a semiquantitative food frequency questionnaire. Am J Epidemiol. 1985; 122(1):51-65. DOI: 10.1093/oxfordjournals.aje.a114086. View

20.

Hallmans G, Agren A, Johansson G, Johansson A, Stegmayr B, Jansson J . Cardiovascular disease and diabetes in the Northern Sweden Health and Disease Study Cohort - evaluation of risk factors and their interactions. Scand J Public Health Suppl. 2003; 61:18-24. DOI: 10.1080/14034950310001432. View