Field Epidemiology
Sex-specific associations between tobacco smoking and risk of cardiovascular diseases in Chinese adults
Qian Shen, Nanbo Zhu, Canqing Yu, Yu Guo, Zheng Bian, Yunlong Tan, Pei Pei, Junshi Chen, Zhengming Chen, Jun Lyu, Liming Li, for the China Kadoorie Biobank (CKB) Collaborative Group
Published 2018-01-10
Cite as Chin J Epidemiol, 2018, 39(1): 8-15. DOI: 10.3760/cma.j.issn.0254-6450.2018.01.002
Abstract
ObjectiveTo examine the sex-specific associations between tobacco smoking and risk of cardiovascular diseases in Chinese adults.
MethodsThe 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 HRs and 95%CI of incident cardiovascular diseases with tobacco smoking.
ResultsDuring 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 HRs (95% CI) 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 P=0.006) and age when smoking started (interaction P=0.011). There was no sex difference in these two effects for ischemic heart diseases, intracerebral hemorrhage and cerebral infarction (all interaction P>0.05).
ConclusionsThis 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.
Key words:
Tobacco smoking; Cardiovascular diseases; Sex specific difference
Contributor Information
Qian Shen
Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
Nanbo Zhu
Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
Canqing Yu
Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
Yu Guo
Chinese Academy of Medical Sciences, Beijing 100010, China
Zheng Bian
Chinese Academy of Medical Sciences, Beijing 100010, China
Yunlong Tan
Chinese Academy of Medical Sciences, Beijing 100010, China
Pei Pei
Chinese Academy of Medical Sciences, Beijing 100010, China
Junshi Chen
China National Center for Food Safety Risk Assessment, Beijing 100020, China
Zhengming Chen
Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford OX3 7LF, UK
Jun Lyu
Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
Liming Li
Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
Chinese Academy of Medical Sciences, Beijing 100010, China
for the China Kadoorie Biobank (CKB) Collaborative Group
