Relation of smoking with carotid artery wall thickness and stenosis in older adults

The Cardiovascular Health Study

G. S. Tell, J. F. Polak, B. J. Ward, S. J. Kittner, P. J. Savage, John A Robbins

Research output: Contribution to journalArticle

112 Citations (Scopus)

Abstract

Background: Cigarette smoking has been associated with increased risk of atherosclerotic diseases in hospital-based studies and in studies of middle- aged populations but not in population-based studies of older adults with and without clinical cardiovascular disease. Methods and Results: We investigated the relation of smoking to carotid artery atherosclerotic disease, expressed as intimal-medial wall thickness and arterial lumen narrowing (stenosis) measured by ultrasound. Subjects were 5116 older adults participating in the baseline examination of the Cardiovascular Health Study, a community-based study of cardiovascular diseases in older age. With increased smoking there was significantly greater internal and common carotid wall thickening and internal carotid stenosis: current smokers>former smokers>never-smokers; for instance, the unadjusted percent stenosis was 24%, 20%, and 16%, respectively (P<.0001). A significant dose-response relation was seen with pack-years of smoking. These findings persisted after adjusting for other cardiovascular risk factors and were also confirmed when analyses were restricted to those without prevalent cardiovascular disease. The difference in internal carotid wall thickness between current smokers and nonsmokers was greater than the difference associated with 10 years of age among never-smoking participants (0.39 mm versus 0.31 mm). Among all participants, the prevalence of clinically significant (≥50%) internal carotid stenosis increased from 4.4% in never-smokers to 7.3% in former smokers to 9.5% in current smokers (P<.0001). Conclusions: These findings extend previous reports of a positive relation between smoking and carotid artery disease to a population-based sample of older adults using several different indicators of atherosclerotic disease.

Original languageEnglish (US)
Pages (from-to)2905-2908
Number of pages4
JournalCirculation
Volume90
Issue number6
StatePublished - 1994
Externally publishedYes

Fingerprint

Carotid Arteries
Pathologic Constriction
Smoking
Carotid Artery Diseases
Health
Cardiovascular Diseases
Carotid Stenosis
Tunica Intima
Population

Keywords

  • atherosclerosis
  • carotid arteries
  • smoking
  • stenosis

ASJC Scopus subject areas

  • Physiology
  • Cardiology and Cardiovascular Medicine

Cite this

Tell, G. S., Polak, J. F., Ward, B. J., Kittner, S. J., Savage, P. J., & Robbins, J. A. (1994). Relation of smoking with carotid artery wall thickness and stenosis in older adults: The Cardiovascular Health Study. Circulation, 90(6), 2905-2908.

Relation of smoking with carotid artery wall thickness and stenosis in older adults : The Cardiovascular Health Study. / Tell, G. S.; Polak, J. F.; Ward, B. J.; Kittner, S. J.; Savage, P. J.; Robbins, John A.

In: Circulation, Vol. 90, No. 6, 1994, p. 2905-2908.

Research output: Contribution to journalArticle

Tell, GS, Polak, JF, Ward, BJ, Kittner, SJ, Savage, PJ & Robbins, JA 1994, 'Relation of smoking with carotid artery wall thickness and stenosis in older adults: The Cardiovascular Health Study', Circulation, vol. 90, no. 6, pp. 2905-2908.
Tell, G. S. ; Polak, J. F. ; Ward, B. J. ; Kittner, S. J. ; Savage, P. J. ; Robbins, John A. / Relation of smoking with carotid artery wall thickness and stenosis in older adults : The Cardiovascular Health Study. In: Circulation. 1994 ; Vol. 90, No. 6. pp. 2905-2908.
@article{30b8b718da98465887e4e3fb4c637961,
title = "Relation of smoking with carotid artery wall thickness and stenosis in older adults: The Cardiovascular Health Study",
abstract = "Background: Cigarette smoking has been associated with increased risk of atherosclerotic diseases in hospital-based studies and in studies of middle- aged populations but not in population-based studies of older adults with and without clinical cardiovascular disease. Methods and Results: We investigated the relation of smoking to carotid artery atherosclerotic disease, expressed as intimal-medial wall thickness and arterial lumen narrowing (stenosis) measured by ultrasound. Subjects were 5116 older adults participating in the baseline examination of the Cardiovascular Health Study, a community-based study of cardiovascular diseases in older age. With increased smoking there was significantly greater internal and common carotid wall thickening and internal carotid stenosis: current smokers>former smokers>never-smokers; for instance, the unadjusted percent stenosis was 24{\%}, 20{\%}, and 16{\%}, respectively (P<.0001). A significant dose-response relation was seen with pack-years of smoking. These findings persisted after adjusting for other cardiovascular risk factors and were also confirmed when analyses were restricted to those without prevalent cardiovascular disease. The difference in internal carotid wall thickness between current smokers and nonsmokers was greater than the difference associated with 10 years of age among never-smoking participants (0.39 mm versus 0.31 mm). Among all participants, the prevalence of clinically significant (≥50{\%}) internal carotid stenosis increased from 4.4{\%} in never-smokers to 7.3{\%} in former smokers to 9.5{\%} in current smokers (P<.0001). Conclusions: These findings extend previous reports of a positive relation between smoking and carotid artery disease to a population-based sample of older adults using several different indicators of atherosclerotic disease.",
keywords = "atherosclerosis, carotid arteries, smoking, stenosis",
author = "Tell, {G. S.} and Polak, {J. F.} and Ward, {B. J.} and Kittner, {S. J.} and Savage, {P. J.} and Robbins, {John A}",
year = "1994",
language = "English (US)",
volume = "90",
pages = "2905--2908",
journal = "Circulation",
issn = "0009-7322",
publisher = "Lippincott Williams and Wilkins",
number = "6",

}

TY - JOUR

T1 - Relation of smoking with carotid artery wall thickness and stenosis in older adults

T2 - The Cardiovascular Health Study

AU - Tell, G. S.

AU - Polak, J. F.

AU - Ward, B. J.

AU - Kittner, S. J.

AU - Savage, P. J.

AU - Robbins, John A

PY - 1994

Y1 - 1994

N2 - Background: Cigarette smoking has been associated with increased risk of atherosclerotic diseases in hospital-based studies and in studies of middle- aged populations but not in population-based studies of older adults with and without clinical cardiovascular disease. Methods and Results: We investigated the relation of smoking to carotid artery atherosclerotic disease, expressed as intimal-medial wall thickness and arterial lumen narrowing (stenosis) measured by ultrasound. Subjects were 5116 older adults participating in the baseline examination of the Cardiovascular Health Study, a community-based study of cardiovascular diseases in older age. With increased smoking there was significantly greater internal and common carotid wall thickening and internal carotid stenosis: current smokers>former smokers>never-smokers; for instance, the unadjusted percent stenosis was 24%, 20%, and 16%, respectively (P<.0001). A significant dose-response relation was seen with pack-years of smoking. These findings persisted after adjusting for other cardiovascular risk factors and were also confirmed when analyses were restricted to those without prevalent cardiovascular disease. The difference in internal carotid wall thickness between current smokers and nonsmokers was greater than the difference associated with 10 years of age among never-smoking participants (0.39 mm versus 0.31 mm). Among all participants, the prevalence of clinically significant (≥50%) internal carotid stenosis increased from 4.4% in never-smokers to 7.3% in former smokers to 9.5% in current smokers (P<.0001). Conclusions: These findings extend previous reports of a positive relation between smoking and carotid artery disease to a population-based sample of older adults using several different indicators of atherosclerotic disease.

AB - Background: Cigarette smoking has been associated with increased risk of atherosclerotic diseases in hospital-based studies and in studies of middle- aged populations but not in population-based studies of older adults with and without clinical cardiovascular disease. Methods and Results: We investigated the relation of smoking to carotid artery atherosclerotic disease, expressed as intimal-medial wall thickness and arterial lumen narrowing (stenosis) measured by ultrasound. Subjects were 5116 older adults participating in the baseline examination of the Cardiovascular Health Study, a community-based study of cardiovascular diseases in older age. With increased smoking there was significantly greater internal and common carotid wall thickening and internal carotid stenosis: current smokers>former smokers>never-smokers; for instance, the unadjusted percent stenosis was 24%, 20%, and 16%, respectively (P<.0001). A significant dose-response relation was seen with pack-years of smoking. These findings persisted after adjusting for other cardiovascular risk factors and were also confirmed when analyses were restricted to those without prevalent cardiovascular disease. The difference in internal carotid wall thickness between current smokers and nonsmokers was greater than the difference associated with 10 years of age among never-smoking participants (0.39 mm versus 0.31 mm). Among all participants, the prevalence of clinically significant (≥50%) internal carotid stenosis increased from 4.4% in never-smokers to 7.3% in former smokers to 9.5% in current smokers (P<.0001). Conclusions: These findings extend previous reports of a positive relation between smoking and carotid artery disease to a population-based sample of older adults using several different indicators of atherosclerotic disease.

KW - atherosclerosis

KW - carotid arteries

KW - smoking

KW - stenosis

UR - http://www.scopus.com/inward/record.url?scp=0028609609&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0028609609&partnerID=8YFLogxK

M3 - Article

VL - 90

SP - 2905

EP - 2908

JO - Circulation

JF - Circulation

SN - 0009-7322

IS - 6

ER -