How does smoking change risk across CVD subtypes?
In ~188k Australians, current smoking raised risk for most CVD subtypes—often at least doubling AMI, stroke, and heart failure—and quitting early cut excess risk.
Source
Tobacco smoking and risk of 36 cardiovascular disease subtypes: fatal and non-fatal outcomes in a large prospective Australian study
Study at a glance
- Design
- Cohort — Prospective 45 and Up Study linked hospitalisation/death for smoking vs CVD subtypes
- N
- N=188167 · CVD- and cancer-free adults ≥45 at baseline
- Population
- Australian general-population adults in the 45 and Up Study
- Outcome
- Fatal/non-fatal CVD hospitalisation and CVD mortality by subtype
Structured fields used in claim comparison tables when every cited study has a complete layer.
What they did
Followed CVD/cancer-free 45 and Up participants with linked hospital and death records, estimating HRs for current/past vs never smokers across many CVD endpoints.
What they found
27,511 major CVD events over mean 7.2 years. Current smoking HRs included 1.63 for major CVD, 2.45 AMI, and 5.06 PAD; paroxysmal tachycardia was newly linked. Dose-response for CVD death and large risk reduction with quitting before 45.
The limits
What it doesn't show
Observational HRs are not randomised treatment effects; residual confounding remains after adjustment.
Key terms
- Hazard ratio (HR)
- Relative event rate comparing exposure groups over follow-up.
- 45 and Up Study
- Large Australian prospective cohort used here.
- Peripheral arterial disease (PAD)
- Atherosclerotic limb artery disease; highest smoking HR here.
- Paroxysmal tachycardia
- Episodic fast heart rhythm newly tied to smoking.
- Population-attributable fraction
- Share of events attributed to smoking in this epidemic setting.
- Current vs never smoker
- Primary exposure contrast for adjusted HRs.
Flashcards
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Baseline cohort size:
Common questions
Baseline n?
188,167 CVD- and cancer-free adults.
Major CVD events?
27,511 over mean 7.2 years.
AMI HR current vs never?
2.45 (2.22–2.70).
Quitting tip from results?
Excess risk largely avoided quitting before age 45.
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