中老年男性吸烟状况与心血管疾病发生风险的关联性  

Association of smoking status with incident cardiovascular disease in the middle-aged and older male populations

作　　者：雷文慧 何诗琪 王豪 周略 余艳秋[1] 刘康 张晓敏[1] 何美安 邬堂春[1] LEI Wen-hui;HE Shi-qi;WANG Hao;ZHOU Lue;YU Yan-qiu;LIU Kang;ZHANG Xiao-min;HE Mei-an;WU Tang-chun(Department of Occupational and Environmental Health and Ministry of Education Key Lab for Environment and Health,School of Public Health,Tongji Medical College,Huazhong University of Science and Technology,,Wuhan 430030,China)

机构地区：[1]华中科技大学同济医学院公共卫生学院劳动卫生与环境卫生学系教育部环境与卫生重点实验室

出　　处：《中华疾病控制杂志》2019年第7期774-779,共6页Chinese Journal of Disease Control & Prevention

基　　金：国家重点研发计划“精准医学研究”(2016YFC0900800)~~

摘　　要：目的探讨中老年男性吸烟状况与心血管疾病(cardiovascular disease,CVD)及其亚型发生风险的关联性。方法本研究选取东风-同济(Dongfeng-Tongji,DFTJ)队列中基线未患冠心病(coronary heart disease,CHD)、中风、癌症、严重心电图异常的13 940名男性为研究对象。研究对象均完成了基线调查,包括问卷调查、体格检查、生化指标检查和血液样本采集。采用Cox比例风险回归模型进行关联性分析,计算风险比(hazard ratio,HR)和95%置信区间(confidence intervals,CI)。结果多因素调整后,与从不吸烟者相比,现在吸烟者发生CVD、CHD和中风的风险增加,吸烟指数≥40包年者发生CVD、CHD和中风的风险HR值分别为1. 49 (95%CI:1.32~1.68,Ptrend=0.001)、1.40(95%CI:1.22~1.62,Ptrend=0. 026)和1.59 (95%CI:1.26~2.00,Ptrend=0.029),开始吸烟年龄<20岁者发生CVD和CHD的风险HR值分别为1.29 (95%CI:1. 06~1.58,Ptrend=0. 007)和1.30 (95%CI:1.03~1.64,Ptrend=0.010);与现在吸烟者相比,戒烟时长≥10年者发生CVD和中风的风险显著降低,HR值分别为0.80 (95%CI:0.71~0. 91,Ptrend=0.017)和0. 65(95%CI:0.50~0.84,Ptrend=0. 207)。结论吸烟能增加CVD、CHD和中风的发生风险,且吸烟指数越大或开始吸烟年龄越小,CVD发生风险越高。戒烟可降低CVD和中风的发生风险。Objective To investigate the association of smoking status with incident cardiovascular disease( CVD) and its subtypes among the middle-aged and older male populations. Methods This study included 13 940 males from Dongfeng-Tongji( DFTJ) cohort who were free of coronary heart disease( CHD),stroke,cancer or severely abnormal electrocardiogram( ECG) at baseline. All participants completed baseline questionnaires,physical examinations,clinical biochemical tests and blood sample collection. Cox proportional hazard models were used to estimate the hazard ratios( HRs) and 95% confident intervals( CI) for the association analyses. Results Compared with never smokers,current smokers had significant higher risks of CVD,CHD and stroke,the adjusted HRs of current smokers who smoked for more than 40 pack-years were 1. 49( 95% CI: 1. 32-1. 68,Ptrend= 0. 001),1. 40( 95%CI: 1. 22-1. 62,Ptrend= 0. 026) and 1. 59( 95% CI: 1. 26-2. 00,Ptrend= 0. 029) for CVD,CHD and stroke,respectively;and the adjusted HRs of current smokers who started smoking before 20 years old were 1. 29( 95% CI: 1. 06-1. 58,Ptrend= 0. 007) and 1. 30( 95% CI: 1. 03-1. 64,Ptrend= 0. 010)for CVD and CHD,respectively. Former smokers who had quitted smoking for 10 or more years had significant lower risks of CVD( HR: 0. 80,95% CI: 0. 71-0. 91,Ptrend= 0. 017) and stroke( HR: 0. 65,95% CI: 0. 50-0. 84,Ptrend= 0. 207) when comparing to current smokers. Conclusions Smoking is significantly associated with higher risks of CVD,CHD and stroke,and greater amount of smoking and earlier age at smoking initiation are associated with a higher risk of CVD. Smoking cessation can reduce the risk of CVD.

关 键 词：吸烟 心血管疾病 前瞻性队列研究 中老年男性 

分 类 号：R541.4[医药卫生—心血管疾病]