Dataset Information

Modified effect of active or passive smoking on the association between age and abdominal aortic calcification: a nationally representative cross-sectional study.

ABSTRACT:

Objective

The deleterious effects of smoking on atherosclerosis were well known; however, the interaction among ageing, smoking and atherosclerosis remains unclear. This study tested the hypothesis that the association between age and vascular calciﬁcation, a critical mark of atherosclerosis, was modified by smoking.

Design

Cross-sectional study.

Setting

A nationally representative sample, the National Health and Nutrition Examination Surveys 2013-2014.

Participants

This study included 3140 adults aged 40-80 years with eligible data for abdominal aortic calcification (AAC). Active and passive smoking exposure was identified through self-reports and tobacco metabolites (serum cotinine and urinary 4-methylnitrosamino-3-pyridyl-1-butanol).

Primary outcome measures

AAC score was determined using dual-energy X-ray absorptiometry (DXA) scans. OR was estimated using the logistic regression method to assess the association between age and the presence of severe or subclinical AAC stratified by smoking exposure. The survey-weighted Wald test was used to evaluate potential interactions.

Results

AAC was positively associated with age in the general population. After adjustment for age, sex, race/ethnicity and other cardiovascular risk factors, age was significantly associated with the odds of severe AAC (OR for each 5-year increase in age: 1.66, 95% CI 1.48 to 1.87, p<0.001). As expected, the association between age and vascular calcification was especially stronger in smokers than in never smokers (p value for interaction ≤0.014). According to spline fitting, the progression of vascular calcification was significantly increased after 45 years in smokers compared with that after 60 years in never smokers. Quitting smoking may compromise the deleteriousness of the vascellum especially in younger adults. However, the difference in age-related calcification among never smokers with or without secondhand smoke exposure was minor, regardless of the definition by self-report, serum cotinine, or urinary 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol.

Conclusions

Smoking significantly accelerated the progression of age-related subclinical atherosclerosis. Early smoking cessation should be encouraged among young smokers. The effect of passive smoking exposure on arteriosclerosis should be assessed further.

SUBMITTER: Lv L

PROVIDER: S-EPMC8520594 | biostudies-literature | 2021 Oct

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Modified effect of active or passive smoking on the association between age and abdominal aortic calcification: a nationally representative cross-sectional study.

Lv Luyan L Wu Shixian S Yang Yungui Y Yue Xiongli X

BMJ open 20211012 10

<h4>Objective</h4>The deleterious effects of smoking on atherosclerosis were well known; however, the interaction among ageing, smoking and atherosclerosis remains unclear. This study tested the hypothesis that the association between age and vascular calciﬁcation, a critical mark of atherosclerosis, was modified by smoking.<h4>Design</h4>Cross-sectional study.<h4>Setting</h4>A nationally representative sample, the National Health and Nutrition Examination Surveys 2013-2014.<h4>Participants</h4> ...[more]

PMID: 34642189

Similar Datasets

Project description:BackgroundAbdominal aortic calcification (AAC) is prevalent among middle-aged and elderly populations, elevating the risk of cardiovascular and cerebrovascular events. Leveraging data from the National Health and Nutrition Examination Survey (NHANES), we conducted a nationally representative cross-sectional study. Our aim was to evaluate whether subjective interventions could influence AAC scores by modifying the antioxidant/pro-oxidant status of individuals and to investigate the role of glycohemoglobin in this relationship.MethodsThe study analyzed data from 1,600 U.S. adults. The study used oxidation balance score (OBS) as an exposure variable derived from 16 dietary and 4 lifestyle factors, as well as glycohemoglobin obtained from blood tests. The main outcome measure was AAC, which was evaluated by dual-energy X-ray absorption and quantified by Kauppila scoring system.ResultsThe mean (SD) age of the 1,600 patients was 56.53 (10.90) years, with a female predominance (50.22%). According to weighted linear regressions not adjusted for covariates, the AAC scores were lower in the third and fourth quartile groups of OBS than in the first quartile group of OBS (Q3: coefficients [coef], -0.92 [95% CI, -1.64 to-0.20], p = 0.017; Q4: coefficients [coef], -0.97 [95% CI, -1.86 ~ -0.08; p < 0.035]). According to the weighted linear regression subgroup analyses, there were no significant OBS-AAC correlations among males (p > 0.05), but there were significant correlations among females (p < 0.05). Smooth fitting curves showed a more significant trend of change in the negative correlation between OBS and AAC scores in postmenopausal women than in premenopausal women. In further mediation analyses, glycohemoglobin was identified as a mediator of the relationship between the oxidative balance score and AAC.ConclusionThis study revealed a significant negative correlation between OBS and AAC scores, particularly in postmenopausal women. The negative correlation between OBS and AAC is partly mediated by glycohemoglobin.

Project description:ObjectivesTo analyse associations between living in social housing and smoking in England and to evaluate progress towards reducing disparities in smoking prevalence among residents of social housing compared with other housing types.DesignCross-sectional analysis of nationally representative data collected between January 2015 and February 2020.SettingEngland.Participants105 562 adults (≥16 years).Primary and secondary outcome measuresLinear and logistic regression were used to analyse associations between living in social housing (vs other housing types) and smoking status, cigarettes per day, time to first cigarette, exposure to others' smoking, motivation to stop smoking, quit attempts and use of cessation support. Analyses were adjusted for sex, age, social grade, region and year.ResultsAdults living in social housing had two times the odds of being a smoker (ORadj=2.17, 95% CI 2.08 to 2.27), and the decline in smoking prevalence between 2015 and 2020 was less pronounced in this high-risk group (-7%; ORadj=0.98, 95% CI 0.96 to 1.01) than among adults living in other housing types (-24%; ORadj=0.95, 95% CI 0.94 to 0.96; housing tenure-survey year interaction p=0.020). Smokers living in social housing were more addicted than those in other housing types (smoking within 30 min of waking: ORadj=1.50, 95% CI 1.39 to 1.61), but were no less motivated to stop smoking (ORadj=1.06, 95% CI 0.96 to 1.17) and had higher odds of having made a serious attempt to quit in the past year (ORadj=1.16, 95% CI 1.07 to 1.25). Among smokers who had tried to quit, those living in social housing had higher odds of using evidence-based cessation support (ORadj=1.22, 95% CI 1.07 to 1.39) but lower odds of remaining abstinent (ORadj=0.63, 95% CI 0.52 to 0.76).ConclusionsThere remain stark inequalities in smoking and quitting behaviour by housing tenure in England, with declines in prevalence stalling between 2015 and 2020 despite progress in the rest of the population. In the absence of targeted interventions to boost quitting among social housing residents, inequalities in health are likely to worsen.

Project description:BackgroundDespite strong efficacy in randomized trials, the population effectiveness of pharmaceutical aids in long-term smoking cessation is lacking, possibly because of confounding (factors that are associated with both pharmaceutical aid use and difficulty quitting). Matching techniques in longitudinal studies can remove this confounding bias.MethodsUsing the nationally representative Tobacco Use Supplement to the Current Population Survey (TUS-CPS), we assessed the effectiveness of medications to aid quitting among baseline adult smokers who attempted to quit prior to one year of follow-up in two longitudinal studies: 2002-2003 and 2010-2011. Pharmaceutical aid users and nonusers with complete data (n = 2129) were matched using propensity score models with 12 potential confounders (age, sex, race-ethnicity, education, smoking intensity, nicotine dependence, previous quit history, self-efficacy to quit, smoke-free homes, survey year, and cessation aid use). Using matched data sets, logistic regression models were fit to assess whether use of any individual pharmaceutical aid increased the proportion of patients who were abstinent for 30 days or more at follow-up.ResultsPropensity score matching markedly improved balance on the potential confounders between the pharmaceutical aid use groups. Using matched samples to provide a balanced comparison, there was no evidence that use of varenicline (adjusted risk difference [aRD] = 0.01, 95% confidence interval [CI] = -0.07 to 0.11), bupropion (aRD = 0.02, 95% CI = -0.04 to 0.09), or nicotine replacement (aRD = 0.01, 95% CI = -0.03 to 0.06) increased the probability of 30 days or more smoking abstinence at one-year follow-up.ConclusionsThe lack of effectiveness of pharmaceutical aids in increasing long-term cessation in population samples is not an artifact caused by confounded analyses. A possible explanation is that counseling and support interventions provided in efficacy trials are rarely delivered in the general population.

Dataset Information

Modified effect of active or passive smoking on the association between age and abdominal aortic calcification: a nationally representative cross-sectional study.

Objective

Design

Setting

Participants

Primary outcome measures

Results

Conclusions

Publications

Modified effect of active or passive smoking on the association between age and abdominal aortic calcification: a nationally representative cross-sectional study.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets