He Yao, Lam Tai Hing, Jiang Bin, Wang Jie, Sai Xiaoyong, Fan Li, Li Xiaoying, Qin Yinhe, Hu Frank B
Institute of Geriatrics, Chinese PLA General Hospital, Beijng, China.
Circulation. 2008 Oct 7;118(15):1535-40. doi: 10.1161/CIRCULATIONAHA.108.784801. Epub 2008 Sep 22.
The association between secondhand smoke (SHS) and risk of peripheral arterial disease (PAD) and stroke remains uncertain.
We examined the relationship between SHS and cardiovascular diseases, particularly PAD and stroke, in Chinese women who never smoked from a population-based cross-sectional study in Beijing, China. SHS exposure was defined as exposure to another person's tobacco smoke at home or in the workplace. Cardiovascular disease events included coronary heart disease, stroke, and PAD. PAD was defined by signs of intermittent claudication as measured by the World Health Organization Rose questionnaire and an ankle-brachial index of <0.90. Among 1209 women who never smoked, 39.5% were exposed to SHS at home or in workplaces. Those individuals who were exposed to SHS had a significantly higher risk of coronary heart disease (adjusted odds ratio [OR], 1.69; 95% CI, 1.31 to 2.18) and ischemic stroke (OR, 1.56; 95% CI, 1.03 to 2.35) than those never exposed to SHS after adjustment for 13 potential risk factors. The adjusted ORs of PAD defined by intermittent claudication, by ankle-brachial index <0.90, and by either intermittent claudication or ankle-brachial index <0.90 were 1.87 (95% CI, 1.30 to 2.68), 1.47 (95% CI, 1.07 to 2.03), and 1.67 (95% CI, 1.23 to 2.16), respectively. Dose-response relationships were found between SHS exposure amount (cigarettes per day) and duration (minutes per day) and increasing prevalence of coronary heart disease, ischemic stroke, and PAD.
In China, SHS exposure in women is highly prevalent. In addition to being a risk factor for coronary heart disease, SHS should be considered an important risk factor for ischemic stroke and PAD in nonsmoking women.
二手烟（SHS）与外周动脉疾病（PAD）及中风风险之间的关联仍不明确。
我们在中国北京一项基于人群的横断面研究中，对从不吸烟的中国女性二手烟暴露与心血管疾病，尤其是外周动脉疾病和中风之间的关系进行了研究。二手烟暴露定义为在家中或工作场所接触他人的烟草烟雾。心血管疾病事件包括冠心病、中风和外周动脉疾病。外周动脉疾病通过世界卫生组织罗斯问卷测量的间歇性跛行体征及踝臂指数<0.90来定义。在1209名从不吸烟的女性中，39.5%在家中或工作场所接触二手烟。在对13个潜在风险因素进行调整后，接触二手烟的个体患冠心病（调整后的优势比[OR]，1.69；95%可信区间[CI]，1.31至2.18）和缺血性中风（OR，1.56；95%CI，1.03至2.35）的风险显著高于未接触二手烟的个体。通过间歇性跛行定义的外周动脉疾病、踝臂指数<0.90定义的外周动脉疾病以及通过间歇性跛行或踝臂指数<0.90定义的外周动脉疾病的调整后OR分别为1.87（95%CI，1.30至2.68）、1.47（95%CI，1.07至2.03）和1.67（95%CI，1.23至2.16）。在二手烟暴露量（每天吸烟支数）和持续时间（每天分钟数）与冠心病、缺血性中风和外周动脉疾病患病率增加之间发现了剂量反应关系。
在中国，女性二手烟暴露非常普遍。除了是冠心病的危险因素外，二手烟还应被视为非吸烟女性缺血性中风和外周动脉疾病的重要危险因素。
