Abstract 14029: Cumulative Cigarette Smoking Exposure and Heart Failure Risk in Older Adults the Health, Aging, and Body Composition (Health ABC) Study
Background: The association between cumulative cigarette smoking exposure and heart failure (HF) risk in older adults has not been well characterized.
Methods: We examined the association between (a) smoking status (current, past, never) and (b) cumulative smoking exposure, as expressed by pack-years of smoking, and incident HF risk in 2125 participants of the Health, Aging, and Body Composition (Health ABC) Study (age, 73.6 ± 2.9 years; 69.7% female; 54.2% white; 45.8% black) using Cox proportional hazard models. In multivariable models, we adjusted for previously identified risk factors for HF in the Health ABC Study and interim coronary events.
Results: During follow-up (median 9.4 years), 231 (10.9%) participants developed incident HF. In models controlling for other HF risk factors and interim coronary events, current smokers were at a significantly higher risk for HF vs. non-smokers (hazard ratio [HR], 1.70; 95% confidence interval [CI], 1.13 to 2.54). In current smokers, risk for HF was not modulated by pack-years of cumulative exposure. In contrast, there was a linear association between cumulative smoking exposure and HF risk among past smokers (HR, 1.11; 95% CI, 1.05 to 1.18 per 10 pack-years of exposure). Compared to non-smokers, HR for HF in past smokers was 1.04 (95% CI, 0.63 to 1.71) for the lowest tertile; 1.24 (95% CI, 0.83 to 1.86) for the intermediate tertile; and 1.68 (95% CI, 1.13 to 2.48) for the highest tertile of pack-years of exposure in adjusted models (p <0.001 for trend across tertiles) (Table 1). Smoking related HF risk was similar across whites vs. blacks, and in both genders. There was no differential association between smoking and HF risk with preserved vs. reduced ejection fraction.
Conclusion: In older adults, both current and past cigarette smoking increase risk for HF. In current smokers, this risk is irrespective of cumulative exposure, whereas in past smokers there appears to be a dose-dependent effect.
- © 2011 by American Heart Association, Inc.