Risk of heart failure and death after prolonged smoking cessation: Role of amount and duration of prior smoking

Amiya A. Ahmed, Kanan Patel, Margaret A. Nyaku, Raya E. Kheirbek, Vera Bittner, Gregg C. Fonarow, Gerasimos S. Filippatos, Charity J. Morgan, Inmaculada B. Aban, Marjan Mujib, Ravi V. Desai, Richard M. Allman, Michel White, Prakash Deedwania, George Howard, Robert O. Bonow, Ross D. Fletcher, Wilbert S. Aronow, Ali Ahmed*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

31 Scopus citations

Abstract

Background-According to the 2004 Surgeon General's Report on Health Consequences of Smoking, after >15 years of abstinence, the cardiovascular risk of former smokers becomes similar to that of never-smokers. Whether this health benefit of smoking cessation varies by amount and duration of prior smoking remains unclear. Methods and Results-Of the 4482 adults ≥65 years without prevalent heart failure (HF) in the Cardiovascular Health Study, 2556 were never-smokers, 629 current smokers, and 1297 former smokers with >15 years of cessation, of whom 312 were heavy smokers (highest quartile; ≥32 pack-years). Age-sex-race-Adjusted hazard ratios (aHR) and 95% confidence intervals (CI) for centrally adjudicated incident HF and mortality during 13 years of follow-up were estimated using Cox regression models. Compared with never-smokers, former smokers as a group had similar risk for incident HF (aHR, 0.99; 95% CI, 0.85-1.16) and all-cause mortality (aHR, 1.08; 95% CI, 0.96-1.20), but former heavy smokers had higher risk for both HF (aHR, 1.45; 95% CI, 1.15-1.83) and mortality (aHR, 1.38; 95% CI, 1.17-1.64). However, when compared with current smokers, former heavy smokers had lower risk of death (aHR, 0.64; 95% CI, 0.53-0.77), but not of HF (aHR, 0.97; 95% CI, 0.74-1.28). Conclusions-After >15 years of smoking cessation, the risk of HF and death for most former smokers becomes similar to that of never-smokers. Although this benefit of smoking cessation is not extended to those with ≥32 packyears of prior smoking, they have lower risk of death relative to current smokers.

Original languageEnglish (US)
Pages (from-to)694-701
Number of pages8
JournalCirculation: Heart Failure
Volume8
Issue number4
DOIs
StatePublished - May 1 2015

Keywords

  • Heart Failure
  • Mortality
  • Smoking

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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