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Investigating the interplay of smoking, cardiovascular risk factors, and overall cardiovascular disease risk: NHANES
Athumani Mambo1,2, Yulu Yang1, Emmerenceana Mahulu3
1Department of Cardiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.
Insights
Smoking significantly elevates cardiovascular disease (CVD) risk, especially when combined with factors like central obesity and hypertension. This combination, along with higher triglycerides and lower HDL-c, presents the highest CVD risk.
Area of Science:
- Cardiovascular Medicine
- Public Health
- Epidemiology
Background:
- Investigates the complex interplay between smoking, cardiovascular disease (CVD) risk factors, and overall CVD risk.
- Utilizes data from the National Health and Nutrition Examination Survey (NHANES) spanning 2011-2018.
Purpose of the Study:
- To analyze demographic, social, and clinical characteristics of participants with and without CVD.
- To determine the associations between various risk factors, including smoking and biomarkers, and CVD risk.
Main Methods:
- Categorized participants based on CVD presence.
- Employed logistic regression, Receiver Operating Characteristics (ROC) analysis, and chi-squared tests.
- Assessed associations between smoking, CVD risk factors, and CVD risk.
Main Results:
- Serum cotinine levels showed a dose-dependent association with CVD risk, with the highest quartile increasing risk 2.33-fold.
- Smoking combined with hypertension, central obesity, diabetes, or elevated triglycerides significantly increased CVD risk.
- A combination of smoking, central obesity, higher triglycerides, lower HDL-c, and hypertension yielded the highest adjusted odds ratio for CVD risk (14.18).
Conclusions:
- Smoking is a major contributor to CVD risk, particularly when co-occurring with other modifiable risk factors.
- The synergistic effect of smoking with central obesity, hypertension, elevated triglycerides, and low HDL-c poses the most substantial CVD risk.
Background:
This study explores the intricate relationship between smoking, cardiovascular disease (CVD) risk factors and their combined impact on overall CVD risk, utilizing data from NHANES 2011-2018.
Methods:
Participants were categorized based on the presence of CVD, and we compared their demographic, social, and clinical characteristics. We utilized logistic regression models, receiver operating characteristics (ROC) analysis, and the chi-squared test to examine the associations between variables and CVD risk.
Results:
Significant differences in characteristics were observed between those with and without CVD. Serum cotinine levels exhibited a dose-dependent association with CVD risk. The highest quartile of cotinine levels corresponded to a 2.33-fold increase in risk. Smoking, especially in conjunction with lower HDL-c, significantly increases CVD risk. Combinations of smoking with hypertension, central obesity, diabetes, and elevated triglycerides also contributed to increased CVD risk. Waist-to-Height Ratio, Visceral Adiposity Index, A Body Shape Index, Conicity Index, Triglyceride-Glucose Index, Neutrophil, Mean platelet volume and Neutrophil to Lymphocyte ratio demonstrated significant associations with CVD risk, with varying levels of significance post-adjustment. When assessing the combined effect of smoking with multiple risk factors, a combination of smoking, central obesity, higher triglycerides, lower HDL-c, and hypertension presented the highest CVD risk, with an adjusted odds ratio of 14.18.
Conclusion:
Smoking, when combined with central obesity, higher triglycerides, lower HDL-c, and hypertension, presented the highest CVD risk, with an adjusted odds ratio of 14.18.
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