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Smoking and risk of coronary heart disease among women with type 2 diabetes mellitus.
Arch Intern Med 2002; 162(3):273-9AI

Abstract

BACKGROUND

Although the association between smoking and increased risk of coronary heart disease (CHD) is well established in the general population, this relationship is less well-defined among individuals with diabetes.

OBJECTIVE

To assess the relationship between cigarette smoking and risk of CHD among women with type 2 diabetes mellitus in the Nurses' Health Study cohort.

METHODS

The Nurses' Health Study, a prospective cohort study of 121,700 US female registered nurses surveyed in 11 states and followed up from July 1, 1976, through July 1, 1996, involved a total of 6547 women diagnosed as having type 2 diabetes mellitus. Incident cases of CHD were our main outcome measure in this study.

RESULTS

We documented 458 incident cases of CHD (200 fatal CHD-related cases and 258 nonfatal myocardial infarctions) during 20 years (68,227 person-years) of follow-up. We found a dose-response relationship between current smoking status and risk of CHD among diabetic women. Compared with never smokers, the relative risks (RRs) for CHD were 1.21 (95% confidence interval [CI], 0.97-1.51) for past smokers, 1.66 (95% CI, 1.10-2.52) for current smokers of 1 to 14 cigarettes per day, and 2.68 (95% CI, 2.07-3.48) for current smokers of 15 or more cigarettes per day in multivariate analyses (P<.001 for trend). The multivariate RR of CHD among diabetic women who had stopped smoking for more than 10 years was similar to that among diabetic women who were never smokers (RR, 1.01; 95% CI, 0.73-1.38). In secondary analyses involving diabetic and nondiabetic women, the multivariate-adjusted RR of CHD for those with diabetes who currently smoked (> or = 15 cigarettes per day) compared with those who never smoked was 7.67 (95% CI, 5.88-10.01).

CONCLUSIONS

Cigarette smoking is strongly associated with an increased risk of CHD among women with type 2 diabetes mellitus. Furthermore, quitting smoking seems to decrease this excess risk substantially; women with diabetes should be strongly advised against smoking.CK

Authors+Show Affiliations

Department of Nutrition, Harvard School of Public Health, 665 Huntington Ave, Boston, MA 02115, USA. wael@hsph.harvard.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

11822919

Citation

Al-Delaimy, Wael K., et al. "Smoking and Risk of Coronary Heart Disease Among Women With Type 2 Diabetes Mellitus." Archives of Internal Medicine, vol. 162, no. 3, 2002, pp. 273-9.
Al-Delaimy WK, Manson JE, Solomon CG, et al. Smoking and risk of coronary heart disease among women with type 2 diabetes mellitus. Arch Intern Med. 2002;162(3):273-9.
Al-Delaimy, W. K., Manson, J. E., Solomon, C. G., Kawachi, I., Stampfer, M. J., Willett, W. C., & Hu, F. B. (2002). Smoking and risk of coronary heart disease among women with type 2 diabetes mellitus. Archives of Internal Medicine, 162(3), pp. 273-9.
Al-Delaimy WK, et al. Smoking and Risk of Coronary Heart Disease Among Women With Type 2 Diabetes Mellitus. Arch Intern Med. 2002 Feb 11;162(3):273-9. PubMed PMID: 11822919.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Smoking and risk of coronary heart disease among women with type 2 diabetes mellitus. AU - Al-Delaimy,Wael K, AU - Manson,JoAnn E, AU - Solomon,Caren G, AU - Kawachi,Ichiro, AU - Stampfer,Meir J, AU - Willett,Walter C, AU - Hu,Frank B, PY - 2002/2/28/pubmed PY - 2002/3/5/medline PY - 2002/2/28/entrez SP - 273 EP - 9 JF - Archives of internal medicine JO - Arch. Intern. Med. VL - 162 IS - 3 N2 - BACKGROUND: Although the association between smoking and increased risk of coronary heart disease (CHD) is well established in the general population, this relationship is less well-defined among individuals with diabetes. OBJECTIVE: To assess the relationship between cigarette smoking and risk of CHD among women with type 2 diabetes mellitus in the Nurses' Health Study cohort. METHODS: The Nurses' Health Study, a prospective cohort study of 121,700 US female registered nurses surveyed in 11 states and followed up from July 1, 1976, through July 1, 1996, involved a total of 6547 women diagnosed as having type 2 diabetes mellitus. Incident cases of CHD were our main outcome measure in this study. RESULTS: We documented 458 incident cases of CHD (200 fatal CHD-related cases and 258 nonfatal myocardial infarctions) during 20 years (68,227 person-years) of follow-up. We found a dose-response relationship between current smoking status and risk of CHD among diabetic women. Compared with never smokers, the relative risks (RRs) for CHD were 1.21 (95% confidence interval [CI], 0.97-1.51) for past smokers, 1.66 (95% CI, 1.10-2.52) for current smokers of 1 to 14 cigarettes per day, and 2.68 (95% CI, 2.07-3.48) for current smokers of 15 or more cigarettes per day in multivariate analyses (P<.001 for trend). The multivariate RR of CHD among diabetic women who had stopped smoking for more than 10 years was similar to that among diabetic women who were never smokers (RR, 1.01; 95% CI, 0.73-1.38). In secondary analyses involving diabetic and nondiabetic women, the multivariate-adjusted RR of CHD for those with diabetes who currently smoked (> or = 15 cigarettes per day) compared with those who never smoked was 7.67 (95% CI, 5.88-10.01). CONCLUSIONS: Cigarette smoking is strongly associated with an increased risk of CHD among women with type 2 diabetes mellitus. Furthermore, quitting smoking seems to decrease this excess risk substantially; women with diabetes should be strongly advised against smoking.CK SN - 0003-9926 UR - https://www.unboundmedicine.com/medline/citation/11822919/Smoking_and_risk_of_coronary_heart_disease_among_women_with_type_2_diabetes_mellitus_ L2 - https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/vol/162/pg/273 DB - PRIME DP - Unbound Medicine ER -