Coronary heart disease risk factors and cigarette smoking among rural African Americans.

Cigarette smoking has been reported to worsen high-density lipoprotein (HDL) cholesterol and other cardiac risk factors, yet no studies have examined this issue among rural African Americans. This study examines the association between cigarette smoking and cardiac risk factors among rural African Americans. A population-based sample of 403 African-American adults from two rural Virginia counties underwent total cholesterol (TC), HDL, systolic and diastolic blood pressure (SBP and DBP), body mass index (BMI), serum glucose, and glycosylated hemoglobin (GlyHb) measurements. Cross-sectional multivariate analyses were used to compare risk factors across categories of cigarette use. Age, BMI, alcohol consumption, and the use of antihypertensive medications were covariates in the analysis. Results indicated that female light smokers had significantly lower SBP and DBP, and lower HDL. Female heavy smokers had significantly lower HDL and BMI and significantly higher TC/HDL ratios. Male heavy smokers had significantly higher SBP. More than 33% of males and more than 50% of females were overweight, and increasing BMI was associated with significantly or nearly significantly worsening of all other risk factor levels. Both cigarette smoking and obesity adversely affect other cardiac risk factors. Novel approaches are needed to decrease both smoking and obesity in this difficult to reach population.