Relationship between cigarette smoking and novel risk factors for cardiovascular disease in the United States
Background: Few studies have examined the relationship between cigarette smoking and novel risk factors for cardiovascular disease in a general population or have included a biochemical marker of current smoking. Objective: To examine the relationship between cigarette smoking and serum C-reactive protein, fibrinogen, and homocysteine levels. Design: Cross-sectional study. Setting: The U.S. general population. Patients: 4187 current smokers, 4791 former smokers, and 8375 never-smokers 18 years of age or older who participated in the Third National Health and Nutrition Examination Survey conducted between 1988 and 1994. Measurements: Serum C-reactive protein levels were categorized as detectable (2.2 to 9.9 mg/L) or clinically elevated (>=10 mg/L), and fibrinogen and homocysteine levels were defined as elevated if in the 85th percentile or greater (11.1 micromol/L and 12.7 mmol/L, respectively). Results: After adjustment for traditional cardiovascular disease risk factors, cigarette smoking was related to elevated levels of C-reactive protein, fibrinogen, and homocysteine. Compared with never smoking cigarettes, self-reported current cigarette smoking was associated with a C-reactive protein level in the detectable (odds ratio, 1.66 [95% CI, 1.40 to 1.97]; P<0.001) or clinically elevated (odds ratio, 1.98 [CI, 1.57 to 2.51]; P<0.001) ranges, with elevated levels of fibrinogen (odds ratio, 2.15 [CI, 1.65 to 2.80]; P<0.001) and homocysteine (odds ratio, 2.10 [CI, 1.62 to 2.74]; P<0.001). There were positive and significant dose-response relationships between measures of cigarette smoking (cigarettes per day, pack-years, and serum cotinine levels) and elevated levels of novel risk factors. Conclusions: These findings suggest that inflammation and hyperhomocysteinemia may be important mechanisms by which smoking promotes atherosclerotic disease.
Publication Name: Annals of Internal Medicine
Dietary Sodium Intake and Subsequent Risk of Cardiovascular Disease in Overweight Adults
Excessive dietary sodium appears to increase the risk of cardiovascular diseases in overweight people but not in people with normal weight. This was the conclusion of researchers who analyzed the risk in 14,407 people, 2,688 of whom were overweight. Among the overweight people, high sodium intake increased the risk of stroke 32%, the risk of death from stroke 89%, the risk of death from cardiovascular disease 61% and the risk of death from any cause 39%. This effect was not seen in people with normal weight.
Publication Name: JAMA, The Journal of the American Medical Association
Passive smoking and the risk of coronary heart disease--a meta-analysis of epidemiologic studies
Passive smoking is clearly linked to an increased risk of heart disease. Researchers used a technique called meta-analysis to evaluate 18 large studies of the effect of passive smoking on the heart. Overall, non-smokers exposed to passive smoke had a 25% increased risk of heart disease compared to those not exposed to passive smoke. Although this risk is rather small, it may represent a significant number of cases of heart disease that could be prevented.
Publication Name: The New England Journal of Medicine
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