Black patients who smoke are twice as likely to develop coronary heart disease (CHD) compared to patients who don’t, according to results from an analysis of data from the Jackson Heart Study.
The study, which was published March 23 in the Journal for the American Heart Association and supported by the National Heart, Lung, and Blood Institute and the National Institute of Minority Health and Health Disparities, constitutes the first close look at the relationship between smoking and CHD for this population, the National Institutes of Health (NIH) noted in a press release. The study was led by Adebamike A. Oshunbade, MD, MPH, of the Department of Medicine at the University of Mississippi Medical Center in Jackson, Mississippi.
For their analysis, Oshunbade and colleagues pulled data on 4,432 participants with no history of CHD during the Jackson Heart Study (2000-2004) who were classified as current smokers, former smokers, or never smokers. After accounting for additional factors such as smoking intensity and number of cigarettes smoked daily, the researchers followed the participants through 2016 to track development of CHD.
“At baseline, there were 548 (12.4%) current, 782 (17.6%) former, and 3,102 (70%) never smokers,” Oshunbade and colleagues wrote. “During follow‐up (median, 13.8 years), 254 participants developed CHD. After risk factor adjustment, CHD risk was significantly higher in current smokers compared with never smokers (HR, 2.11; 95% CI, 1.39-3.18); the difference between former smokers and never smokers (HR, 1.37; 95% CI, 1.0-1.90) did not achieve statistical significance. Among current smokers, we did not observe a dose‐response effect for CHD risk. Additionally, in multivariable logistic regression models with a subset of our analytic cohort, current smokers had greater odds of coronary artery calcification score >0 compared with never smokers (odds ratio, 2.63; 95% CI, 1.88-3.68).”
These results suggest that reducing smoking prevalence among the Black population could substantially reduce CHD morbidity, particularly given that Black patients are more likely to die from CHD than White patients in the U.S. However, despite a decline in smoking among Black adults in recent years, NIH suggested that healthcare disparities may inhibit efforts to cut numbers further.
“Smoking is a modifiable risk factor for cardiovascular disease and 73% of African American adults who smoke want to quit,” said David Goff, MD, PhD, director of the NHLBI’s Division of Cardiovascular Sciences, in a statement. “However, compared to whites, African American patients are less likely to receive information about smoking cessation treatments that we know can make a difference. Fully addressing tobacco-related disparities requires addressing conditions where people live, work, and play.”
Oshunbade and colleagues noted that their study was observational, and that the findings cannot confirm a causal link between smoking and CHD. Furthermore, as the study was only conducted among Black patients from one area, the findings may not be generalizable to other racial/ethnic populations or other regions of the U.S.
John McKenna, Associate Editor, BreakingMED™
Cat ID: 914
Topic ID: 74,914,730,914,143,192,151,925
