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CV risk in former light smokers reduced sooner than in heavy smokers


 

AT THE 2013 AHA SCIENTIFIC SESSIONS

DALLAS – Older people who quit their moderate smoking habit reduced their cigarette-associated cardiovascular risks to the level seen people who had never smoked in as little as 8 years, according to a prospective population study.

This risk reversal occurred much sooner than the 15 years predicted in a 2004 report by the U.S. Surgeon General. This is yet another study to highlight the cardiovascular benefits of smoking cessation, and the message remains the same: "If you’re not a smoker, don’t start. And if you’re a smoker, quit, and quit early," said Dr. Ali Ahmed, professor of cardiovascular disease and gerontology, geriatrics, and palliative care at the University of Alabama at Birmingham and professor of epidemiology at the School of Public Health there. He presented his study at the American Heart Association’s annual scientific sessions.

They narrowed down the Cardiovascular Health Study population to 3,409 adults, 65 years and older, who were free of baseline heart failure. Of the 850 former smokers, roughly 320 had smoked less than 32 pack-years. They had quit within the past 15 years, with the median of 8 years.

Adjusted and age-sex-race adjusted findings during 13 years of follow-up showed that the risk of incident heart failure and cardiovascular mortality were similar between former light smokers and never-smokers.

The light smokers, defined as individuals smoking less than 32 pack-years, who quit smoking less than 15 years ago, had an 18% risk of incident heart failure, compared with 21% in never-smoker; and 14% risk of cardiovascular mortality, compared with 17% in never-smokers. However, their risk of all-cause and noncardiovascular mortality remained significantly higher than in never-smokers.

In previous studies, Dr. Ahmed and his associates had shown that former heavy smokers (32 or more pack-years) may be at increased risk of cardiovascular disease, even after 15 years. (Circulation 2010;122:A17788; Circulation 2011;124:A18263). The team wanted to find out whether smoking less than 32 pack-years would mean earlier reversal of cardiovascular risk.

Dr. Ahmed said that the cardiovascular benefits of quitting smoking, which – unlike mutations or damage to alveolar lining – is reversible, begins within 24 hours after cessation, unless the damage has reached a threshold of no return from heavy smoking.

Dr. Ahmed had no disclosures.

nmiller@frontlinemedcom.com

On Twitter @NaseemSMiller

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