Abstract 17788: Heavy Smoking in the Past Is a Risk Factor for Incident Heart Failure in Older Adults Despite ≥15 Years of Abstinence: Findings from a Prospective Population Study
Background: The 2004 Surgeon General's Report, “The Health Consequences of Smoking” suggests that after 15 years of abstinence, the cardiovascular (CV) risk of smoking becomes similar to that of never-smokers. According to the CDC, the prevalence of smoking among those ≥65 years is low (∼10%, v. >20% for those <65 yrs), and many may be ex-smokers. Therefore, we examined the long-term effect of past smoking on incident heart failure (HF) among community-dwelling adults ≥65 years in the Cardiovascular Health Study (CHS).
Methods: Of the 5338 CHS participants without prevalent HF, 2780 (52%) had a smoking history. After excluding 1483 current or recent (<15 years) smokers, the remaining 3855 current non-smokers were categorized as never smokers (n=2558) or remote-smokers who quit smoking >15 years ago (n=1297). We used a multivariable (MV) Cox regression model to estimate the associations of quartiles of smoking pack-year (PY) among remote-smokers (reference, never-smokers) with incident HF during 12 years of follow-up. The model was adjusted for demographics and other CV risk factors including intercurrent acute myocardial infarction (AMI) occurring before incident HF (n=188).
Results: Participants (n=3855) had a mean (±SD) age of 74 (±6) years, 59% were women, and 14% African American. The unadjusted and MV-adjusted associations of smoking PY quartiles for remote-smokers (with >15 years of abstinence) with incident HF are displayed in the Table. When smoking PY was used as a continuous variable, every 10 PY increase in smoking was associated with a significant 6% increase in the risk of incident HF. Compared with never-smokers, remote-smokers with the highest quartile PY smoking also had increased risk of AMI and all-cause mortality.
Conclusions: In community-dwelling older adults, compared to never-smokers, remote-smokers (with >15 years of abstinence) with over 30 PY of smoking history had a significant increased risk of incident HF. .
- © 2010 by American Heart Association, Inc.