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Smoking Linked to Peripheral Artery Disease in Women

Increase in PAD incidence in women with no prior heart disease is independent of other variables

TUESDAY, June 7 (HealthDay News) -- Smoking increases the risk of symptomatic peripheral artery disease (PAD) in women with no cardiovascular disease, according to a study published in the June 7 issue of the Annals of Internal Medicine.

David Conen, M.D., M.P.H., from University Hospital in Basel, Switzerland, and colleagues investigated the association between current smoking status, cumulative exposure, and smoking cessation with the incidence of symptomatic PAD in 39,825 women with no cardiovascular disease. The participants were followed up for an average of 12.7 years, during which time the incidence of PAD and the risk of PAD were compared across smoking categories (never, former, <15 cigarettes/day, and ≥15 cigarettes/day).

The investigators identified 178 events of PAD with age-adjusted incidence rates increasing across the four smoking categories from 0.12 for never, 0.34 for former smokers, 0.95 for <15 cigarettes/day, and 1.63 for ≥15 cigarettes/day per 1,000 person-years of follow-up. Multivariate adjustments had little impact on this association. The risk levels increased significantly in 28,314 participants after adjusting for high-sensitivity C-reactive protein and soluble intercellular adhesion molecule-1 levels (hazard ratios [HRs], 5.58 for <15 cigarettes/day and 9.52 for ≥15 cigarettes/day). A strong dose-response relationship was seen for adjusted lifetime exposure (adjusted HRs, 2.52, 6.75, and 11.09 for smoking abstinence of <10, 10 to 29, and ≥30 pack-years, respectively). Compared to current smokers, those who abstained from smoking had lower adjusted PAD risk (adjusted HRs for <10 years, 10 to 20 years, >20 years, or lifelong abstinence were 0.39 0.28, 0.16, and 0.08, respectively).

"Our large prospective study emphasizes the importance of smoking as a risk factor for symptomatic PAD," the authors write.

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