Abstract:
BACKGROUND:Tobacco smoking is a leading cause of cardiovascular disease (CVD) morbidity and mortality. Evidence on the relation of smoking to different subtypes of CVD, across fatal and non-fatal outcomes, is limited. METHODS:A prospective study of 188,167 CVD- and cancer-free individuals aged ≥ 45 years from the Australian general population joining the 45 and Up Study from 2006 to 2009, with linked questionnaire, hospitalisation and death data up to the end of 2015. Hazard ratios (HRs) for hospitalisation with or mortality from CVD among current and past versus never smokers were estimated, including according to intensity and recency of smoking, using Cox regression, adjusting for age, sex, urban/rural residence, alcohol consumption, income and education. Population-attributable fractions were estimated. RESULTS:During a mean 7.2 years follow-up (1.35 million person-years), 27,511 (crude rate 20.4/1000 person-years) incident fatal and non-fatal major CVD events occurred, including 4548 (3.2) acute myocardial infarction (AMI), 3991 (2.8) cerebrovascular disease, 3874 (2.7) heart failure and 2311 (1.6) peripheral arterial disease (PAD) events. At baseline, 8% of participants were current and 34% were past smokers. Of the 36 most common specific CVD subtypes, event rates for 29 were increased significantly in current smokers. Adjusted HRs in current versus never smokers were as follows: 1.63 (95%CI 1.56-1.71) for any major CVD, 2.45 (2.22-2.70) for AMI, 2.16 (1.93-2.42) for cerebrovascular disease, 2.23 (1.96-2.53) for heart failure, 5.06 (4.47-5.74) for PAD, 1.50 (1.24-1.80) for paroxysmal tachycardia, 1.31 (1.20-1.44) for atrial fibrillation/flutter, 1.41 (1.17-1.70) for pulmonary embolism, 2.79 (2.04-3.80) for AMI mortality, 2.26 (1.65-3.10) for cerebrovascular disease mortality and 2.75 (2.37-3.19) for total CVD mortality. CVD risks were elevated at almost all levels of current smoking intensity examined and increased with smoking intensity, with HRs for total CVD mortality in current versus never smokers of 1.92 (1.11-3.32) and 4.90 (3.79-6.34) for 4-6 and ≥ 25 cigarettes/day, respectively. Risks diminished with quitting, with excess risks largely avoided by quitting before age 45. Over one third of CVD deaths and one quarter of acute coronary syndrome hospitalisations in Australia aged < 65 can be attributed to smoking. CONCLUSIONS:Current smoking increases the risk of virtually all CVD subtypes, at least doubling the risk of many, including AMI, cerebrovascular disease and heart failure. Paroxysmal tachycardia is a newly identified smoking-related risk. Where comparisons are possible, smoking-associated relative risks for fatal and non-fatal outcomes are similar. Quitting reduces the risk substantially. In an established smoking epidemic, with declining and low current smoking prevalence, smoking accounts for a substantial proportion of premature CVD events.
journal_name
BMC Medjournal_title
BMC medicineauthors
Banks E,Joshy G,Korda RJ,Stavreski B,Soga K,Egger S,Day C,Clarke NE,Lewington S,Lopez ADdoi
10.1186/s12916-019-1351-4subject
Has Abstractpub_date
2019-07-03 00:00:00pages
128issue
1issn
1741-7015pii
10.1186/s12916-019-1351-4journal_volume
17pub_type
杂志文章相关文献
BMC Medicine文献大全abstract:BACKGROUND:While step counter use has become popular among type 2 diabetes (T2D) patients, its effectiveness in increasing physical activity (PA) and improving glycemic control has been poorly defined. The aim of this meta-analysis of randomized controlled trials (RCTs) was to evaluate the association of step counter u...
journal_title:BMC medicine
pub_type: 杂志文章,meta分析
doi:10.1186/1741-7015-12-36
更新日期:2014-02-27 00:00:00
abstract:BACKGROUND:Inappropriate treatment of non-malaria fevers with artemisinin-based combination therapies (ACTs) is a growing concern, particularly in light of emerging artemisinin resistance, but it is a behavior that has proven difficult to change. Pay for performance (P4P) programs have generated interest as a mechanism...
journal_title:BMC medicine
pub_type: 杂志文章,随机对照试验
doi:10.1186/s12916-015-0497-y
更新日期:2015-10-16 00:00:00
abstract:BACKGROUND:Alcoholic beverages are widely consumed. Depression, the most prevalent mental disorder worldwide, has been related to alcohol intake. We aimed to prospectively assess the association between alcohol intake and incident depression using repeated measurements of alcohol intake. METHODS:We followed-up 5,505 h...
journal_title:BMC medicine
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1186/1741-7015-11-192
更新日期:2013-08-30 00:00:00
abstract:BACKGROUND:Predicting treatment benefit and/or outcome before any therapeutic intervention has taken place would be clinically very useful. Herein, we evaluate the ability of the intrinsic subtypes and the risk of relapse score at diagnosis to predict survival and response following neoadjuvant chemotherapy. In additio...
journal_title:BMC medicine
pub_type: 杂志文章
doi:10.1186/s12916-015-0540-z
更新日期:2015-12-18 00:00:00
abstract:BACKGROUND:Renal impairment is a major risk factor for mortality in various populations. Three formulas are frequently used to assess both glomerular filtration rate (eGFR) or creatinine clearance (CrCl) and mortality prediction: body surface area adjusted-Cockcroft-Gault (CG-BSA), Modification of Diet in Renal Disease...
journal_title:BMC medicine
pub_type: 杂志文章,随机对照试验
doi:10.1186/s12916-016-0731-2
更新日期:2016-11-10 00:00:00
abstract:BACKGROUND:Lethal and edema toxins secreted by Bacillus anthracis during anthrax infection were found to incite serious cardiovascular complications. However, the underlying mechanisms in anthrax lethal toxin-induced cardiac anomalies remain unknown. This study was designed to evaluate the impact of antioxidant enzyme ...
journal_title:BMC medicine
pub_type: 杂志文章
doi:10.1186/1741-7015-10-134
更新日期:2012-11-07 00:00:00
abstract::Environmental enteropathy (EE) is a poorly defined state of intestinal inflammation without overt diarrhea that occurs in individuals exposed over time to poor sanitation and hygiene. It is implicated as a cause of stunting and malnutrition, oral vaccine failure and impaired development in children from low-income cou...
journal_title:BMC medicine
pub_type: 评论,杂志文章
doi:10.1186/s12916-014-0187-1
更新日期:2014-10-14 00:00:00
abstract:BACKGROUND:It has been presumed that Chlamydia trachomatis is transmitted between men only through anal or oral sex, but no mathematical models have tested this presumption. METHODS:To test this presumption, we created 20 compartmental mathematical models of different sexual practices that included both oral and anal ...
journal_title:BMC medicine
pub_type: 杂志文章
doi:10.1186/s12916-020-01796-3
更新日期:2020-11-17 00:00:00
abstract::A series of primarily laboratory-based studies found attention bias modification in socially anxious participants to lead to reduced anxiety. It is argued that the failure to replicate the positive results of attention bias modification in the study of Carlbring et al. may be due to reasons other than the application ...
journal_title:BMC medicine
pub_type: 杂志文章
doi:10.1186/1741-7015-10-63
更新日期:2012-06-25 00:00:00
abstract:BACKGROUND:Thymic size in early infancy predicts subsequent survival in low-income settings. The human thymus develops from early gestation, is most active in early life and is highly sensitive to malnutrition. Our objective was to test whether thymic size in infancy could be increased by maternal and/or infant nutriti...
journal_title:BMC medicine
pub_type: 杂志文章,随机对照试验
doi:10.1186/s12916-019-1264-2
更新日期:2019-02-18 00:00:00
abstract:BACKGROUND:The vascular contributions to neurodegeneration and neuroinflammation may be assessed by magnetic resonance imaging (MRI) and ultrasonography (US). This review summarises the methodology for these widely available, safe and relatively low cost tools and analyses recent work highlighting their potential utili...
journal_title:BMC medicine
pub_type: 杂志文章,评审
doi:10.1186/s12916-017-0799-3
更新日期:2017-02-09 00:00:00
abstract::In recent years, the introduction and Federal Drug Administration approval of immune checkpoint inhibitor antibodies has dramatically improved the clinical outcomes for patients with advanced melanoma. These antagonist monoclonal antibodies are capable of unleashing dormant or exhausted antitumor immunity, which has l...
journal_title:BMC medicine
pub_type: 杂志文章,评审
doi:10.1186/s12916-016-0571-0
更新日期:2016-02-06 00:00:00
abstract:BACKGROUND:Skin toxicity is a common side effect of radiotherapy for solid tumors. Its management can cause treatment gaps and thus can impair cancer treatment. At present, in many countries no standard recommendation for treatment of skin during radiotherapy exists. In this study, we explored the effect of topically-a...
journal_title:BMC medicine
pub_type: 杂志文章
doi:10.1186/1741-7015-4-28
更新日期:2006-12-01 00:00:00
abstract:BACKGROUND:Caregivers may promote the uptake of science into patient care and the practice of evidence-informed medicine. The purpose of this study was to determine whether caregiver-mediated (non-clinical caregiver-delivered) interventions are effective in improving patient, caregiver, provider, or health system outco...
journal_title:BMC medicine
pub_type: 杂志文章,评审
doi:10.1186/s12916-018-1097-4
更新日期:2018-07-12 00:00:00
abstract:BACKGROUND:The 'Older People's Exercise intervention in Residential and nursing Accommodation' (OPERA) cluster randomised trial evaluated the impact of training for care home staff together with twice-weekly, physiotherapist-led exercise classes on depressive symptoms in care home residents, but found no effect. We rep...
journal_title:BMC medicine
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1186/1741-7015-12-1
更新日期:2014-01-03 00:00:00
abstract:BACKGROUND:Medical apps are widely available, increasingly used by patients and clinicians, and are being actively promoted for use in routine care. However, there is little systematic evidence exploring possible risks associated with apps intended for patient use. Because self-medication errors are a recognized source...
journal_title:BMC medicine
pub_type: 杂志文章,评审
doi:10.1186/s12916-015-0314-7
更新日期:2015-05-06 00:00:00
abstract:BACKGROUND:The declining efficacy of dihydroartemisinin-piperaquine against Plasmodium falciparum in Cambodia, along with increasing numbers of recrudescent cases, suggests resistance to both artemisinin and piperaquine. Available in vitro piperaquine susceptibility assays do not correlate with treatment outcome. A nov...
journal_title:BMC medicine
pub_type: 杂志文章
doi:10.1186/s12916-015-0539-5
更新日期:2015-12-22 00:00:00
abstract:BACKGROUND:Complex neurodevelopmental disorders may be characterized by subtle brain function signatures early in life before behavioral symptoms are apparent. Such endophenotypes may be measurable biomarkers for later cognitive impairments. The nonlinear complexity of electroencephalography (EEG) signals is believed t...
journal_title:BMC medicine
pub_type: 杂志文章
doi:10.1186/1741-7015-9-18
更新日期:2011-02-22 00:00:00
abstract:BACKGROUND:Congregate settings may serve as institutional amplifiers of tuberculosis (TB) and multidrug-resistant tuberculosis (MDR-TB). We analyze spatial, epidemiological, and pathogen genetic data prospectively collected from neighborhoods surrounding a prison in Lima, Peru, where inmates experience a high risk of M...
journal_title:BMC medicine
pub_type: 杂志文章
doi:10.1186/s12916-018-1111-x
更新日期:2018-08-03 00:00:00
abstract:BACKGROUND:Human T lymphotropic virus type I (HTLV-I)-associated myelopathy/tropical spastic paraparesis (HAM/TSP) is a chronic myelopathy characterized by motor dysfunction of the lower extremities and urinary disturbance. Immunomodulatory treatments are the main strategy for HAM/TSP, but several issues are associated...
journal_title:BMC medicine
pub_type: 临床试验,杂志文章
doi:10.1186/1741-7015-11-182
更新日期:2013-08-15 00:00:00
abstract:BACKGROUND:We aimed to show the non-inferiority of home fortification with a daily dose of 3 mg iron in the form of iron as ferric sodium ethylenediaminetetraacetate (NaFeEDTA) compared with 12.5 mg iron as encapsulated ferrous fumarate in Kenyan children aged 12-36 months. In addition, we updated a recent meta-analysi...
journal_title:BMC medicine
pub_type: 杂志文章,随机对照试验
doi:10.1186/s12916-017-0839-z
更新日期:2017-04-28 00:00:00
abstract:BACKGROUND:The benefit-risk balance of vaccines is regularly debated by the public, but the utility of media monitoring for regulatory bodies is unclear. A media monitoring study was conducted at the European Medicines Agency (EMA) concerning human papillomavirus (HPV) vaccines during a European Union (EU) referral pro...
journal_title:BMC medicine
pub_type: 杂志文章
doi:10.1186/s12916-017-0850-4
更新日期:2017-05-02 00:00:00
abstract:BACKGROUND:The peer review process is a cornerstone of biomedical research. We aimed to evaluate the impact of interventions to improve the quality of peer review for biomedical publications. METHODS:We performed a systematic review and meta-analysis. We searched CENTRAL, MEDLINE (PubMed), Embase, Cochrane Database of...
journal_title:BMC medicine
pub_type: 杂志文章,meta分析,评审
doi:10.1186/s12916-016-0631-5
更新日期:2016-06-10 00:00:00
abstract:BACKGROUND:We update a previous systematic review to inform new World Health Organization HIV self-testing (HIVST) recommendations. We compared the effects of HIVST to standard HIV testing services to understand which service delivery models are effective for key populations. METHODS:We did a systematic review of rand...
journal_title:BMC medicine
pub_type: 杂志文章
doi:10.1186/s12916-020-01835-z
更新日期:2020-12-03 00:00:00
abstract::Although strong evidence exists that the benefits of vaccination by far outweigh potential adverse events, controversy still exists. This has led opponents of vaccination to question its safety, efficacy and necessity. In an interview with Professor Elizabeth Miller, we discuss the continuum of beliefs held by vaccine...
journal_title:BMC medicine
pub_type: 面试
doi:10.1186/s12916-015-0508-z
更新日期:2015-10-16 00:00:00
abstract:BACKGROUND:Antiretroviral therapy (ART) alters platelet reactivity, and as a consequence, patients living with HIV may be at an increased risk of cardiovascular disease (CVD). The current evidence on platelet activation levels in patients with HIV remains inconclusive. We therefore aimed to systematically synthesise ev...
journal_title:BMC medicine
pub_type: 杂志文章
doi:10.1186/s12916-020-01801-9
更新日期:2020-11-18 00:00:00
abstract:BACKGROUND:Although vaccination has been proved to be a safe, efficacious, and cost-effective intervention, immunisation rates remain suboptimal in many European countries, resulting in poor control of many vaccine-preventable diseases. DISCUSSION:The Summit of Independent European Vaccination Experts focused on the p...
journal_title:BMC medicine
pub_type: 杂志文章
doi:10.1186/1741-7015-5-11
更新日期:2007-05-29 00:00:00
abstract:BACKGROUND:Alcohol consumption is a leading contributor to death and disability worldwide, but previous research has not examined the effects of different patterns of alcohol consumption. The study objective was to understand the relationship between different alcohol consumption patterns and adverse health outcomes ri...
journal_title:BMC medicine
pub_type: 杂志文章
doi:10.1186/s12916-020-01878-2
更新日期:2021-01-12 00:00:00
abstract:BACKGROUND:The mind-body nexus has been a topic of growing interest. Further data are however required to understand the specific relationship between mood and anxiety disorders and individual physical health conditions, and to verify whether these psychiatric disorders are linked to overall medical burden. METHODS:Th...
journal_title:BMC medicine
pub_type: 杂志文章
doi:10.1186/1741-7015-11-110
更新日期:2013-04-24 00:00:00
abstract::Migraine is a highly prevalent neurological disorder imparting a major burden on health care around the world. The primary pathology may be a state of hyperresponsiveness of the nervous system, but the molecular mechanisms are yet to be fully elucidated. We could now be at a watershed moment in this respect, as the ge...
journal_title:BMC medicine
pub_type: 杂志文章,评审
doi:10.1186/1741-7015-9-116
更新日期:2011-10-25 00:00:00