Impact of smoking and smoking cessation on cardiovascular events and mortality among older adults: meta-analysis of individual participant data from prospective cohort studies of the CHANCES consortium

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Impact of smoking and smoking cessation on cardiovascular events and mortality among older adults : meta-analysis of individual participant data from prospective cohort studies of the CHANCES consortium

Mons, Ute (författare): German Canc Res Ctr, Div Clin Epidemiol & Aging Res, D-69120 Heidelberg, Germany.

Mueezzinler, Aysel (författare): German Canc Res Ctr, Div Clin Epidemiol & Aging Res, D-69120 Heidelberg, Germany.;Heidelberg Univ, NAR, Heidelberg, Germany.

Gellert, Carolin (författare): German Canc Res Ctr, Div Clin Epidemiol & Aging Res, D-69120 Heidelberg, Germany.

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Schoettker, Ben (författare): German Canc Res Ctr, Div Clin Epidemiol & Aging Res, D-69120 Heidelberg, Germany.

Abnet, Christian C. (författare): NCI, Bethesda, MD 20892 USA.

Bobak, Martin (författare): UCL, Dept Epidemiol & Publ Hlth, London, England.

de Groot, Lisette (författare): Wageningen Univ, Div Human Nutr, NL-6700 AP Wageningen, Netherlands.

Freedman, Neal D. (författare): NCI, Bethesda, MD 20892 USA.

Jansen, Eugene (författare): Natl Inst Publ Hlth & Environm RIVM, Ctr Hlth Protect, Bilthoven, Netherlands.

Kee, Frank (författare): Queens Univ Belfast, UKCRC Ctr Excellence Publ Hlth, Belfast, Antrim, North Ireland.

Kromhout, Daan (författare): Wageningen Univ, Div Human Nutr, NL-6700 AP Wageningen, Netherlands.

Kuulasmaa, Kari (författare): Natl Inst Hlth & Welf THL, Helsinki, Finland.

Laatikainen, Tiina (författare): Natl Inst Hlth & Welf THL, Helsinki, Finland.;Univ Eastern Finland, Inst Publ Hlth & Clin Nutr, Kuopio, Finland.;Hosp Dist North Karelia, Joensuu, Finland.

O'Doherty, Mark G. (författare): Queens Univ Belfast, UKCRC Ctr Excellence Publ Hlth, Belfast, Antrim, North Ireland.

Bueno-de-Mesquita, Bas (författare): Natl Inst Publ Hlth & Environm RIVM, Dept Determinants Chron Dis DCD, Bilthoven, Netherlands.;Univ Med Ctr, Dept Gastroenterol & Hepatol, Utrecht, Netherlands.;Univ London Imperial Coll Sci Technol & Med, Sch Publ Hlth, Dept Epidemiol & Biostat, London, England.;Univ Malaya, Fac Med, Dept Social & Prevent Med, Kuala Lumpur, Malaysia.

Orfanos, Philippos (författare): Hellen Hlth Fdn, Athens, Greece.;Univ Athens, Sch Med, Dept Hyg Epidemiol & Med Stat, GR-11527 Athens, Greece.

Peters, Annette (författare): Helmholtz Zentrum Munchen, Inst Epidemiol 2, Neuherberg, Germany.;German Ctr Cardiovasc Dis Res DZHK eV, Munich, Germany.

van der Schouw, Yvonne T. (författare): Univ Med Ctr Utrecht, Julius Ctr Hlth Sci & Primary Care, Dept Epidemiol, Utrecht, Netherlands.

Wilsgaard, Tom (författare): UiT Arctic Univ Norway, Dept Community Med, Tromso, Norway.

Wolk, Alicja (författare): Karolinska Institutet,Karolinska Inst, Inst Environm Med, S-10401 Stockholm, Sweden.

Trichopoulou, Antonia (författare): Hellen Hlth Fdn, Athens, Greece.;Univ Athens, Sch Med, Dept Hyg Epidemiol & Med Stat, GR-11527 Athens, Greece.

Boffetta, Paolo (författare): Hellen Hlth Fdn, Athens, Greece.;Icahn Sch Med Mt Sinai, Inst Translat Epidemiol, New York, NY 10029 USA.;Icahn Sch Med Mt Sinai, Tisch Canc Inst, New York, NY 10029 USA.

Brenner, Hermann (författare): German Canc Res Ctr, Div Clin Epidemiol & Aging Res, D-69120 Heidelberg, Germany.

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German Canc Res Ctr, Div Clin Epidemiol & Aging Res, D-69120 Heidelberg, Germany German Canc Res Ctr, Div Clin Epidemiol & Aging Res, D-69120 Heidelberg, Germany.;Heidelberg Univ, NAR, Heidelberg, Germany. (creator_code:org_t)

2015-04-20
2015
Engelska.
Ingår i: The BMJ. - : BMJ PUBLISHING GROUP. - 1756-1833. ; 350

Relaterad länk:: https://www.bmj.com/...; visa fler...; https://urn.kb.se/re...; https://doi.org/10.1...; http://kipublication...; visa färre...

Tidskriftsartikel (refereegranskat)

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OBJECTIVE To investigate the impact of smoking and smoking cessation on cardiovascular mortality, acute coronary events, and stroke events in people aged 60 and older, and to calculate and report risk advancement periods for cardiovascular mortality in addition to traditional epidemiological relative risk measures. DESIGN Individual participant meta-analysis using data from 25 cohorts participating in the CHANCES consortium. Data were harmonised, analysed separately employing Cox proportional hazard regression models, and combined by meta-analysis. RESULTS Overall, 503 905 participants aged 60 and older were included in this study, of whom 37 952 died from cardiovascular disease. Random effects meta-analysis of the association of smoking status with cardiovascular mortality yielded a summary hazard ratio of 2.07 (95% CI 1.82 to 2.36) for current smokers and 1.37 (1.25 to 1.49) for former smokers compared with never smokers. Corresponding summary estimates for risk advancement periods were 5.50 years (4.25 to 6.75) for current smokers and 2.16 years (1.38 to 2.39) for former smokers. The excess risk in smokers increased with cigarette consumption in a dose-response manner, and decreased continuously with time since smoking cessation in former smokers. Relative risk estimates for acute coronary events and for stroke events were somewhat lower than for cardiovascular mortality, but patterns were similar. CONCLUSIONS Our study corroborates and expands evidence from previous studies in showing that smoking is a strong independent risk factor of cardiovascular events and mortality even at older age, advancing cardiovascular mortality by more than five years, and demonstrating that smoking cessation in these age groups is still beneficial in reducing the excess risk.

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Impact of smoking and smoking cessation on cardiovascular events and mortality among older adults : meta-analysis of individual participant data from prospective cohort studies of the CHANCES consortium

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