Shen Q, Zhu N B, Yu C Q, Guo Y, Bian Z, Tan Y L, Pei P, Chen J S, Chen Z M, Lyu J, Li L M
Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China.
Chinese Academy of Medical Sciences, Beijing 100010, China.
Zhonghua Liu Xing Bing Xue Za Zhi. 2018 Jan 10;39(1):8-15. doi: 10.3760/cma.j.issn.0254-6450.2018.01.002.
To examine the sex-specific associations between tobacco smoking and risk of cardiovascular diseases in Chinese adults. The present analysis included 487 373 participants from the China Kadoorie Biobank after excluding those with cancer, heart diseases, stroke at baseline survey. The baseline survey was conducted from June 2004 to July 2008. The number of follow-up years was calculated from the time that the participants completed baseline survey to the time of any event: CVD incidence, death, loss of follow-up, or December 31, 2015, whichever occurred first. We used Cox proportional hazards regression models to estimate the s and 95% of incident cardiovascular diseases with tobacco smoking. During a median follow-up of 8.9 years(a total of 4.1 million person years), we documented 33 947 cases of ischemic heart diseases, 6 048 cases of major coronary diseases, 7 794 cases of intracerebral hemorrhage, and 31 722 cases of cerebral infarction. The prevalence of smoking was much higher in men (67.9%) than in women (2.7%). Smoking increased risk of all subtypes of cardiovascular diseases. Compared with nonsmokers, the multivariable-adjusted s (95% ) for current smokers were 1.54 (1.43-1.66) for major coronary event, 1.28 (1.24-1.32) for ischemic heart disease, 1.18 (1.14-1.22) for cerebral infarction, and 1.07 (1.00-1.15) for intracerebral hemorrhage, respectively. Female smokers tended to have greater risk of developing major coronary event associated with amount of tobacco smoked daily (interaction =0.006) and age when smoking started (interaction =0.011). There was no sex difference in these two effects for ischemic heart diseases, intracerebral hemorrhage and cerebral infarction (all interaction >0.05). This prospective study confirmed increased risk of all subtypes of cardiovascular diseases in current smokers. Smoking was more harmful to women than to men for major coronary event.
为研究中国成年人吸烟与心血管疾病风险之间的性别特异性关联。本分析纳入了中国嘉道理生物银行的487373名参与者，排除了在基线调查时患有癌症、心脏病、中风的人群。基线调查于2004年6月至2008年7月进行。随访年限从参与者完成基线调查之时计算至任何事件发生之时：心血管疾病发病、死亡、失访或2015年12月31日，以先发生者为准。我们使用Cox比例风险回归模型来估计吸烟与心血管疾病发病的风险比及95%置信区间。在中位随访8.9年（总计410万人年）期间，我们记录了33947例缺血性心脏病病例、6048例主要冠状动脉疾病病例、7794例脑出血病例和31722例脑梗死病例。男性吸烟率（67.9%）远高于女性（2.7%）。吸烟会增加所有心血管疾病亚型的风险。与不吸烟者相比，当前吸烟者发生主要冠状动脉事件的多变量调整风险比（95%置信区间）为1.54（1.43 - 1.66），缺血性心脏病为1.28（1.24 - 1.32），脑梗死为1.18（1.14 - 1.22），脑出血为1.07（1.00 - 1.15）。女性吸烟者发生主要冠状动脉事件的风险往往与每日吸烟量（交互作用 = 0.006）和开始吸烟时的年龄（交互作用 = 0.011）相关。对于缺血性心脏病、脑出血和脑梗死，这两种影响不存在性别差异（所有交互作用>0.05）。这项前瞻性研究证实了当前吸烟者所有心血管疾病亚型的风险增加。对于主要冠状动脉事件，吸烟对女性的危害大于男性。
