Association of smoking cessation and weight change with cardiovascular disease among adults with and without diabetes.

Détails

Ressource 1Télécharger: BIB_BEE21ECD2477.P001.pdf (583.95 [Ko])
Etat: Public
Version: de l'auteur
ID Serval
serval:BIB_BEE21ECD2477
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Association of smoking cessation and weight change with cardiovascular disease among adults with and without diabetes.
Périodique
JAMA
Auteur(s)
Clair C., Rigotti N.A., Porneala B., Fox C.S., D'Agostino R.B., Pencina M.J., Meigs J.B.
ISSN
1538-3598 (Electronic)
ISSN-L
0098-7484
Statut éditorial
Publié
Date de publication
2013
Peer-reviewed
Oui
Volume
309
Numéro
10
Pages
1014-1021
Langue
anglais
Notes
Publication types: Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov'tPublication Status: ppublish. PDF type: ORIGINAL CONTRIBUTION
Résumé
IMPORTANCE: Smoking cessation reduces the risks of cardiovascular disease (CVD), but weight gain that follows quitting smoking may weaken the CVD benefit of quitting.
OBJECTIVE: To test the hypothesis that weight gain following smoking cessation does not attenuate the benefits of smoking cessation among adults with and without diabetes.
DESIGN, SETTING, AND PARTICIPANTS: Prospective community-based cohort study using data from the Framingham Offspring Study collected from 1984 through 2011. At each 4-year examination, self-reported smoking status was assessed and categorized as smoker, recent quitter (≤ 4 years), long-term quitter (>4 years), and nonsmoker. Pooled Cox proportional hazards models were used to estimate the association between quitting smoking and 6-year CVD events and to test whether 4-year change in weight following smoking cessation modified the association between smoking cessation and CVD events.
MAIN OUTCOME MEASURE: Incidence over 6 years of total CVD events, comprising coronary heart disease, cerebrovascular events, peripheral artery disease, and congestive heart failure.
RESULTS: After a mean follow-up of 25 (SD, 9.6) years, 631 CVD events occurred among 3251 participants. Median 4-year weight gain was greater for recent quitters without diabetes (2.7 kg [interquartile range {IQR}, -0.5 to 6.4]) and with diabetes (3.6 kg [IQR, -1.4 to 8.2]) than for long-term quitters (0.9 kg [IQR, -1.4 to 3.2] and 0.0 kg [IQR, -3.2 to 3.2], respectively, P < .001). Among participants without diabetes, age- and sex-adjusted incidence rate of CVD was 5.9 per 100 person-examinations (95% CI, 4.9-7.1) in smokers, 3.2 per 100 person-examinations (95% CI, 2.1-4.5) in recent quitters, 3.1 per 100 person-examinations (95% CI, 2.6-3.7) in long-term quitters, and 2.4 per 100 person-examinations (95% CI, 2.0-3.0) in nonsmokers. After adjustment for CVD risk factors, compared with smokers, recent quitters had a hazard ratio (HR) for CVD of 0.47 (95% CI, 0.23-0.94) and long-term quitters had an HR of 0.46 (95% CI, 0.34-0.63); these associations had only a minimal change after further adjustment for weight change. Among participants with diabetes, there were similar point estimates that did not reach statistical significance.
CONCLUSIONS AND RELEVANCE: In this community-based cohort, smoking cessation was associated with a lower risk of CVD events among participants without diabetes, and weight gain that occurred following smoking cessation did not modify this association. This supports a net cardiovascular benefit of smoking cessation, despite subsequent weight gain.
Mots-clé
Adult, Aged, Cardiovascular Diseases/epidemiology, Diabetes Mellitus/epidemiology, Female, Humans, Incidence, Male, Middle Aged, Prevalence, Prospective Studies, Risk Factors, Smoking Cessation, United States/epidemiology, Weight Gain
Pubmed
Web of science
Open Access
Oui
Création de la notice
12/04/2013 17:22
Dernière modification de la notice
20/08/2019 15:33
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