Burke GM, et al. – This research incorporated the inspection of the hypothesis that the contribution of tobacco to cardiovascular disease (CVD) risk would be attenuated over prospective decades (1971–2006) in a community–based cohort. The results underscored the significance of persistent public health efforts focusing on smoking as a modifiable exposure, which strongly contributed towards CVD risk.

Methods

• 5,041 Framingham Heart Study Offspring Cohort enrollees (mean age 36.1 years, 52% women) without prevalent CVD were examined.
• Data was extracted on smoking status, relevant CVD risk factors, and incident CVD events across prospective decades.
• The multivariable-adjusted, Cox proportional hazard models estimated the effect of smoking on incident cardiovascular disease over three, prospective 12-year follow-up periods.

Results

• A consistent 2-fold increased risk of CVD was observed in men who smoke compared to nonsmokers for each 12-year time period spanning from 1971 to 2006.
• Women who smoked reported a 1.5-fold increased CVD risk.
• Smoking persisted as a significant risk factor regardless of the substantial improvements in the prevention and treatment of CVD.
• Significant, contemporary improvements in CVD prevention, for instance, gains in hypertension and cholesterol treatment did not attenuate the strong and persistent associations of smoking with CVD.