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Article: 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

TitleImpact 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
Authors
Issue Date2009
PublisherBioMed Central Ltd. The Journal's web site is located at http://www.biomedcentral.com/bmcpublichealth/
Citation
BMC Public Health, 2009, v. 9, article no. 294 How to Cite?
AbstractBACKGROUND: 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 non-smokers 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.
Persistent Identifierhttp://hdl.handle.net/10722/86675
ISSN
2015 Impact Factor: 2.209
2015 SCImago Journal Rankings: 1.372
PubMed Central ID
ISI Accession Number ID
Funding AgencyGrant Number
National Health and Medical Research Council of Australia358395
Pfizer Inc.
Ministry of Health WelfareA040152
New South Wales and National Heart Foundation of Australia Career Development Award
Wellcome Trust
Assistance Publique-Hopitaux de Paris
Funding Information:

This project has received support from a National Health and Medical Research Council of Australia program grant (358395) and an unrestricted educational grant from Pfizer Inc. Partial support was also obtained from the Korean Health 21 Research and Development Project of the Ministry of Health & Welfare (A040152). The sponsors had no influence on design, analysis or interpretation of results, and took no part in the writing of this paper. Rachel Huxley is supported by a New South Wales and National Heart Foundation of Australia Career Development Award. David Batty is a Wellcome Trust Fellow. Sebastien Czernichow is funded by research grants from the Institut Servier France and from the Assistance Publique-Hopitaux de Paris. The authors are grateful to Gary Whitlock for providing comments on an earlier manuscript.

 

DC FieldValueLanguage
dc.contributor.authorHuxley, RRen_HK
dc.contributor.authorNakamura, Ken_HK
dc.contributor.authorLam, THen_HK
dc.contributor.authorBarzi, Fen_HK
dc.contributor.authorBatty, GDen_HK
dc.contributor.authorCzernichow, Sen_HK
dc.contributor.authorUeshima, Hen_HK
dc.contributor.authorKim, HCen_HK
dc.contributor.authorWong, JWen_HK
dc.contributor.authorFang, Xen_HK
dc.contributor.authorFeigin, Ven_HK
dc.contributor.authorWoodward, Men_HK
dc.date.accessioned2010-09-06T09:19:57Z-
dc.date.available2010-09-06T09:19:57Z-
dc.date.issued2009en_HK
dc.identifier.citationBMC Public Health, 2009, v. 9, article no. 294en_HK
dc.identifier.issn1471-2458en_HK
dc.identifier.urihttp://hdl.handle.net/10722/86675-
dc.description.abstractBACKGROUND: 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 non-smokers 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.-
dc.languageengen_HK
dc.publisherBioMed Central Ltd. The Journal's web site is located at http://www.biomedcentral.com/bmcpublichealth/en_HK
dc.relation.ispartofBMC Public Healthen_HK
dc.rightsCreative Commons: Attribution 3.0 Hong Kong Licenseen_HK
dc.subject.meshBody Mass Index-
dc.subject.meshCoronary Disease - epidemiology - physiopathology-
dc.subject.meshSmoking-
dc.subject.meshStroke - epidemiology - physiopathology-
dc.subject.meshTobacco-
dc.titleImpact 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 regionen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=1471-2458&volume=9&spage=294&epage=&date=2009&atitle=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+regionen_HK
dc.identifier.emailLam, TH: hrmrlth@hkucc.hku.hken_HK
dc.identifier.authorityLam, TH=rp00326en_HK
dc.description.naturepublished_or_final_version-
dc.identifier.doi10.1186/1471-2458-9-294-
dc.identifier.pmid19678933-
dc.identifier.pmcidPMC2734855-
dc.identifier.scopuseid_2-s2.0-69549108653-
dc.identifier.hkuros164035en_HK
dc.identifier.volume9, article no. 294-
dc.identifier.isiWOS:000269666600001-
dc.publisher.placeUnited Kingdom-
dc.identifier.citeulike5435838-

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