How broadly does smoking raise heart and vessel disease risk?
In a large Australian cohort, current smoking raised risk across nearly all CVD subtypes—especially peripheral arterial disease—and quitting lowered risk.
Source
Tobacco smoking and risk of 36 cardiovascular disease subtypes: fatal and non-fatal outcomes in a large prospective Australian study
What they did
Using the 45 and Up Study with 1.35 million person-years of follow-up, investigators compared current and past smokers with never smokers for dozens of fatal/non-fatal CVD subtypes.
What they found
Among 27,511 major CVD events, current smoking elevated risks for IHD/AMI, stroke, heart failure, and especially PAD (RR ~5). Risks were intermediate in former smokers; quitting reduces risk. Even paroxysmal tachycardia risk was implicated.
The limits
What it doesn't show
Observational residual confounding is possible despite adjustment; subtype risks vary and are not identical.
Key terms
- CVD subtypes
- Distinct cardiovascular diagnoses such as AMI, stroke, heart failure, and PAD.
- Current vs never smoker
- Comparison of people smoking at baseline versus those who never smoked.
- Peripheral arterial disease
- Atherosclerotic disease of limb arteries, highly smoking-related here.
- Smoking-attributable risk
- Disease burden theoretically linked to tobacco use.
- 45 and Up Study
- Large prospective cohort of Australian adults.
Flashcards
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Quiz yourself
Major CVD events numbered about:
Common questions
How many major CVD events?
27,511 fatal and non-fatal events.
Which subtype had especially high RR?
Peripheral arterial disease (about fivefold).
Do former smokers look like never smokers?
Risks were intermediate—quitting helps but history matters.
New signal mentioned?
Increased risk of paroxysmal tachycardia.
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