被动吸烟与心脏病发作或冠心病死亡风险

Passive smoking and the risk of heart attack or coronary death.

作者信息

Dobson A J, Alexander H M, Heller R F, Lloyd D M

机构信息

Centre for Clinical Epidemiology and Biostatistics, Royal Newcastle Hospital, Newcastle, NSW.

出版信息

Med J Aust. 1991 Jun 17;154(12):793-7. doi: 10.5694/j.1326-5377.1991.tb121366.x.

DOI:10.5694/j.1326-5377.1991.tb121366.x

PMID:2041503

Abstract

OBJECTIVES

To estimate the prevalence of passive smoking in an Australian population, the magnitude of risk of myocardial infarction or coronary death associated with passive smoking and the extent to which fibrinogen concentrations might be affected by passive smoking.

DESIGN

A population-based case-control study of myocardial infarction or coronary death and passive smoking, and measurement of fibrinogen in a random sample from the same population.

SETTING AND PARTICIPANTS

Residents of the Lower Hunter Region of New South Wales aged 35-69 years in 1988-1989. Case subjects were all those who suffered myocardial infarction or coronary death. Control subjects were participants in a risk factor prevalence survey.

OUTCOME MEASURES

Myocardial infarction or coronary death, defined by criteria of the WHO MONICA Project, and fibrinogen concentration (measured in controls only).

RESULTS

Prevalence of passive smoking at home was 20% for male case subjects, 13% for male control subjects, 29% for female case subjects and 19% for female control subjects. The corresponding prevalence rates for passive smoking at work were 40%, 44%, 41% and 37%. Odds ratios of myocardial infarction or coronary death for active smokers compared with non-smokers were 4.70 (95% confidence interval [CI], 3.35-6.58) in women and 2.71 (95% CI, 2.07-3.53) in men. For women the odds ratios of myocardial infarction or coronary death for those exposed to passive smoking at home were 2.46 (95% CI, 1.47-4.13) among non-smokers and 1.48 (95% CI, 0.67-3.30) among ex-smokers. For men the odds ratios for passive smoking at home were 0.97 (95% CI, 0.50-1.86) for non-smokers and 1.78 (95% CI, 1.13-2.79) for ex-smokers. The odds ratios for passive smoking at work did not suggest increased risk. Fibrinogen concentrations were generally higher among people exposed to passive smoking at home or work compared with those not exposed but were not as high as concentrations in active smokers.

CONCLUSIONS

Passive smoking increases the risk of coronary heart disease and increased fibrinogen concentration provides a marker of its effect.

摘要

目的

评估澳大利亚人群中被动吸烟的患病率、与被动吸烟相关的心肌梗死或冠心病死亡风险程度，以及被动吸烟可能影响纤维蛋白原浓度的程度。

设计

一项基于人群的心肌梗死或冠心病死亡与被动吸烟的病例对照研究，并对同一人群的随机样本进行纤维蛋白原测量。

背景与参与者

1988 - 1989年新南威尔士州下亨特地区35 - 69岁的居民。病例对象为所有发生心肌梗死或冠心病死亡的人。对照对象为一项危险因素患病率调查的参与者。

观察指标

根据世界卫生组织MONICA项目标准定义的心肌梗死或冠心病死亡，以及纤维蛋白原浓度（仅在对照中测量）。

结果

在家中被动吸烟的患病率，男性病例对象为20%，男性对照对象为13%，女性病例对象为29%，女性对照对象为19%。在工作场所被动吸烟的相应患病率分别为40%、44%、41%和37%。与不吸烟者相比，现吸烟者发生心肌梗死或冠心病死亡的比值比在女性中为4.70（95%置信区间[CI]，3.35 - 6.58），在男性中为2.71（95%CI，2.07 - 3.53）。对于女性，在家中接触被动吸烟的非吸烟者发生心肌梗死或冠心病死亡的比值比为2.46（95%CI，1.47 - 4.13），既往吸烟者为1.48（95%CI，0.67 - 3.30）。对于男性，在家中被动吸烟的非吸烟者比值比为0.97（95%CI，0.50 - 1.86），既往吸烟者为1.78（95%CI，1.13 - 2.79）。在工作场所被动吸烟的比值比未提示风险增加。与未接触者相比，在家中或工作场所接触被动吸烟的人纤维蛋白原浓度普遍较高，但不如现吸烟者的浓度高。