Mamun Abdullah Al, Peeters Anna, Barendregt Jan, Willekens Frans, Nusselder Wilma, Bonneux Luc
University of Groningen, Groningen, The Netherlands.
Eur Heart J. 2004 Mar;25(5):409-15. doi: 10.1016/j.ehj.2003.12.015.
To compare the burden of cardiovascular disease in terms of lifetime risk and life years lived with disease between smokers and non-smokers.
We constructed multi-state life tables describing transitions through various cardiovascular diseases for 4723 smokers and non-smokers observed during 20 biannual observations in the Original Framingham Heart Study. Non-smokers live 8.66 (95% CI 7.61-9.63) (men) and 7.59 (95% CI 6.33-8.92) (women) years longer than smokers and more years free of cardiovascular disease: 6.22 (95% CI 5.09-7.30) years for males and 4.93 (95% CI 3.54-6.29) for females. But non-smokers spend more years with cardiovascular disease over the life course: 2.43 (95% CI 1.72-3.16) years for males and 2.66 (95% CI 1.87-3.38) years for females. The risk of cardiovascular disease before age 70 is higher among smokers, but over the entire lifecourse male non-smokers have higher risks of coronary heart disease, myocardial infarction, stroke and congestive heart failure, and female non-smokers have higher risks of coronary heart disease and congestive heart failure.
Smoking, by shortening life, decreases both the probability and duration of cardiovascular disease throughout the life course. Non-smokers live many years longer and longer free of cardiovascular disease than smokers, but at the end of their life non-smokers will have lived longer with cardiovascular disease.
比较吸烟者和非吸烟者在心血管疾病终生风险及带病生存年限方面的疾病负担。
我们构建了多状态生命表，描述了在原弗雷明汉心脏研究中每半年观察一次的4723名吸烟者和非吸烟者在各种心血管疾病之间的转变情况。非吸烟者比吸烟者寿命长8.66年（95%置信区间7.61 - 9.63）（男性）和7.59年（95%置信区间6.33 - 8.92）（女性），且无心血管疾病的时间更长：男性为6.22年（95%置信区间5.09 - 7.30），女性为4.93年（95%置信区间3.54 - 6.29）。但非吸烟者在整个生命过程中患心血管疾病的时间更长：男性为2.43年（95%置信区间1.72 - 3.16），女性为2.66年（95%置信区间1.87 - 3.38）。70岁之前吸烟者患心血管疾病的风险更高，但在整个生命过程中，男性非吸烟者患冠心病、心肌梗死、中风和充血性心力衰竭的风险更高，女性非吸烟者患冠心病和充血性心力衰竭的风险更高。
吸烟通过缩短寿命，降低了整个生命过程中心血管疾病的发生概率和持续时间。非吸烟者比吸烟者寿命长很多，且无心血管疾病的时间更长，但在生命末期，非吸烟者患心血管疾病的生存时间会更长。
