Department of Nursing, Tongmyong University, Busan 48520, Korea.
Red Cross College of Nursing, Chung-Ang University, Seoul 06974, Korea.
Int J Environ Res Public Health. 2019 Jul 29;16(15):2697. doi: 10.3390/ijerph16152697.
Smoking is a well-known risk factor for atherosclerotic cardiovascular disease. However, there are insufficient data regarding the predictive influence of smoking status on the risk of incident heart failure (HF). This study involved a systematic review and meta-analysis of prospective cohort studies to identify the association of smoking status with incident risk of HF. Peer-reviewed articles published in PubMed, Embase, Web of Science, Cochrane, and CINAHL up to May 2019 were identified. Seven studies, based on 42,759 participants and 4826 HF cases, were included. Pooled hazard ratios (HRs) and their 95% confidence intervals (CI) were estimated using the fixed effects model. Subgroup analyses were conducted to define possible sources of heterogeneity. Current smokers aged 18 years and over had a greater risk of HF incidence compared with non-smokers (never or former smokers) (HR = 1.609, 95% CI, 1.470-1.761). Additionally, former smokers had a greater risk of HF incidence compared with never smokers (HR = 1.209, 95% CI, 1.084-1.348). The present study highlighted that never smokers have more obvious cardiovascular benefits than current or former smokers. Therefore, health professionals should support cessation at the earliest among current smokers and encourage young people and non-smokers not to start smoking.
吸烟是动脉粥样硬化性心血管疾病的已知危险因素。然而，关于吸烟状况对心力衰竭（HF）发病风险的预测影响的数据不足。本研究对前瞻性队列研究进行了系统评价和荟萃分析，以确定吸烟状况与 HF 发病风险的相关性。检索了 PubMed、Embase、Web of Science、Cochrane 和 CINAHL 中截至 2019 年 5 月的同行评审文章。纳入了 7 项研究，共 42759 名参与者和 4826 例 HF 病例。使用固定效应模型估计合并危险比（HR）及其 95%置信区间（CI）。进行亚组分析以确定异质性的可能来源。与从不吸烟者（从不吸烟者或前吸烟者）相比，年龄在 18 岁及以上的当前吸烟者发生 HF 的风险更高（HR=1.609，95%CI，1.470-1.761）。此外，与从不吸烟者相比，前吸烟者发生 HF 的风险更高（HR=1.209，95%CI，1.084-1.348）。本研究强调，从不吸烟者比当前吸烟者或前吸烟者具有更明显的心血管获益。因此，卫生专业人员应尽早在当前吸烟者中支持戒烟，并鼓励年轻人和不吸烟者不要开始吸烟。
