Institution: | 1. Department of Public Health Sciences, Graduate School of Public Health, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul 08826, Republic of Korea;2. Korea Center for Gendered Innovations for Science and Technology Research (GISTeR), 22 Teheran-ro 7-gil, Gangnam-gu, Seoul 06130, Republic of Korea;3. Department of Food and Nutrition, School of Food Science and Technology, Chung-Ang University, 4726 Seodong-daero, Daedeok-myeon, Anseong, Gyeonggi-do 17546, Republic of Korea;1. 2nd Department of Internal Medicine, Medical Faculty of Charles University and University Hospital, Pilsen, Czech Republic;2. Biomedical Center, Medical Faculty of Charles University, Pilsen, Czech Republic;3. Centre for Cardiovascular Prevention, First Faculty of Medicine, Charles, University and Thomayer Hospital, Prague, Czech Republic;4. Laboratory of Immunochemical Diagnostics, University Hospital, Pilsen, Czech Republic;1. Department of Medicine, University of Verona, Verona, Italy;2. Department of Neuroscience, Biomedicine and Movement, University of Verona, Verona, Italy;3. Department of Medicine, Section of Geriatrics, Healthy Aging Center Verona, Italy;4. Section of Geriatrics, Department of Medicine, Treviso, Italy;1. Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China;2. Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai Key Laboratory for Endocrine Tumor, State Key Laboratory of Medical Genomics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China;1. Center for Chronic Disease Control, Nanshan, Shenzhen, PR China;2. Department of Nutrition, School of Public Health, Sun Yat-sen University, GuangZhou, PR China;3. Department of Epidemiology, School of Public Health, Sun Yat-sen University, GuangZhou, PR China;4. Department of Health Management, Beijing Xiaotangshan Hospital, Beijing, PR China;5. School of Public Health, Shenzhen University Health Science Center, Shenzhen, PR China |
Abstract: | Background and aimsCardiovascular disease (CVD) and hypertension are the main causes of global death. We aimed to investigate the independent and combined effects of smoking and alcohol consumption on CVD risk among Koreans with elevated blood pressure (BP).Methods and resultsAdults aged 20–65 years with elevated BP and without pre-existing CVDs were selected from the National Health Insurance Service-National Sample Cohort version 2.0. We followed up 59,391 men and 35,253 women between 2009 and 2015. The association of CVD incidence with smoking pack-years and alcohol consumption was investigated using the multivariate Cox proportional hazard model. Among women, smokers (10.1–20.0 pack-years) and alcohol drinkers (≥30.0 g/day) had higher CVD risks (hazard ratio HR] = 1.15, 95% confidence intervals CI] 1.06–1.25, HR = 1.06, 95% CI 1.00–1.12, respectively) compared to each referent group. However, men who smoked exhibited an increased CVD risk only with pack-years >20.0 (HR = 1.09, 1.03–1.14 and HR = 1.18, 1.11–1.26 for smokers with 20.1–30.0 and ≥ 30.1 pack-years, respectively) compared to nonsmokers. In the combined groups of those smoking and consuming alcohol, only nonsmoking men consuming alcohol 1.0–29.9 g/day had a lower CVD risk than did nonsmoking, nondrinking men (HR = 0.90, 0.83–0.97). Women smoking 1.0-10.0 pack-years and consuming alcohol ≥30.0 g/day had a higher CVD risk (HR = 1.25, 1.11–1.41) than nonsmoking and nondrinking women.ConclusionSmoking and alcohol consumption, independently and jointly, were associated with CVD risk in men and women. Women had a greater CVD risk than did men among Korean adults with elevated BP. |