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Maalouf E, Hallit S, Salameh P, Hosseini H. Eating Behaviors, Lifestyle, and Ischemic Stroke: A Lebanese Case-Control Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1487. [PMID: 36674240 PMCID: PMC9864864 DOI: 10.3390/ijerph20021487] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 01/10/2023] [Accepted: 01/12/2023] [Indexed: 05/29/2023]
Abstract
BACKGROUND Stroke is the second leading cause of death and the third leading cause of disability on a global scale. Most clinicians tend to underestimate the importance of diet and inadequate or dysfunctional eating attitudes in patients with a complicated relationship with food. Concerned about the potential of an independent Lebanese approach, and also because prior international research has revealed a link between eating intake or choice and ischemic stroke risk, it was considered vital to broaden the scope of the literature and evaluate further the association of disordered eating attitudes and focus on the distinct relationship with food in the case of orthorexia nervosa (ON) in the Lebanese community. Consequently, the purpose of the present study is to investigate the potential association between pre-existing disordered eating attitudes, specifically ON, and ischemic stroke risk, with an emphasis on the evidence supporting a Mediterranean-style diet. METHODS This research is a case-control survey study involving 113 Lebanese individuals with ischemic stroke and 451 age-(within 5 years) and sex-matched controls recruited from several hospitals in Lebanon (April 2020-April 2021). RESULTS According to the findings of our first regression model, living 100 m from a crowded road (adjusted odds ratio [aOR]: 3.421, 95% confidence interval [CI]: 1.585-7.387), living 100 m from an electricity generator (aOR: 3.686, 95% CI: 1.681-8.085), higher waterpipe dependence (aOR: 1.204, 95% CI: 1.117-1.297), higher exposure to passive smoking (aOR: 2.651, 95% CI: 2.051-3.426), being married (aOR: 3.545, 95% CI: 1.297-9.689), having a low educational attainment (aOR: 0.239, 95% CI: 0.084-0.679), vigorous physical activity (aOR: 1.003, 95% CI: 1.001-1.006), and having more inappropriate eating (aOR: 1.040, 95% CI: 1.006-1.074) were all associated with higher odds of having ischemic stroke. Furthermore, atrial fibrillation (aOR: 2.945, 95% CI: 1.010-8.585), diabetes (aOR: 2.550, 95% CI: 1.169-5.561), heart diseases (aOR: 6.193, 95% CI: 2.196-17.463), and hypertension (aOR: 2.744, 95% CI: 1.049-7.180) were also linked to an increased risk of stroke. Moreover, having more orthorexia nervosa tendencies (aOR: 1.123, 95% CI: 1.021-1.235) was related to a higher odds of having an ischemic stroke, whereas better adherence to the MeD was significantly linked (aOR: 0.691, 95% CI: 0.583-0.819) to lower odds of ischemic stroke. CONCLUSIONS Ischemic stroke patients were more likely to have disordered eating attitudes and orthorexic behaviors. Furthermore, the MeD has been found to be beneficial in reducing ischemic stroke risk. Despite the study's focus, outdoor pollution, waterpipe dependence, and passive smoking were linked to ischemic stroke. In summary, this review suggests that improving one's nutritional status and making a few lifestyle changes are key stroke prevention and treatment methods.
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Affiliation(s)
- Elise Maalouf
- Life and Health Sciences Department, Paris-Est University, 94000 Creteil, France
| | - Souheil Hallit
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, Jounieh P.O. Box 446, Lebanon
- Applied Science Research Center, Applied Science Private University, Amman 11931, Jordan
- Research Department, Psychiatric Hospital of the Cross, Jal Eddib P.O. Box 60096, Lebanon
| | - Pascale Salameh
- School of Medicine, Lebanese American University, Byblos 5053, Lebanon
- INSPECT-LB: Institut National de Santé Publique, Épidémiologie Clinique et Toxicologie-Liban, Beirut 1103, Lebanon
- Medical School, University of Nicosia, Nicosia 2417, Cyprus
- Faculty of Pharmacy, Lebanese University, Beirut 1103, Lebanon
| | - Hassan Hosseini
- UPE-C, Université Paris-Est Créteil, Faculté de Santé, INSERM U955-E01, IMRB, 94000 Creteil, France
- Hopital Henri Mondor, APHP, 94000 Creteil, France
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Brust JC. Stroke and Substance Abuse. Stroke 2022. [DOI: 10.1016/b978-0-323-69424-7.00039-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Becher H, Aigner A. Methods to estimate proportion and number of nonexposed cases in a population. Biom J 2020; 63:514-527. [PMID: 33150987 DOI: 10.1002/bimj.201900190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2019] [Revised: 09/09/2020] [Accepted: 09/11/2020] [Indexed: 11/09/2022]
Abstract
National mortality statistics commonly provide disease-specific absolute and relative frequencies of death by sex and age, but not by exposure status. However, it is often of interest to know how many of the diseased individuals, that is the cases, were exposed or not exposed to a specific risk factor. We present two methods to estimate the proportion and the number of exposed and nonexposed cases, both of which require an estimate of the exposure prevalence in the nondiseased population. Method I additionally requires an estimate of the relative effect of exposure, that is a relative risk function if the exposure has a continuous distribution, or a relative risk estimate for each category if the exposure is categorical. Method II additionally requires an estimate of the disease rate among the nonexposed. We provide theoretical justifications, discuss practical limitations, and provide an R script to calculate the probability for nonexposure among the diseased, and compare the approaches. Both methods are subsequently applied to the estimation of the number of never smokers among lung cancer deaths. The two suggested methods rely on the availability of specific data sources and might therefore be applicable in different research settings. Both methods yield unbiased estimates of the number of nonexposed cases, given that the respective underlying assumptions are fulfilled.
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Affiliation(s)
- Heiko Becher
- Universitätsklinikum Hamburg-Eppendorf, Institut für Medizinische Biometrie und Epidemiologie, Hamburg, Germany.,Charité - Universitätsmedizin Berlin, Institut für Biometrie und klinische Epidemiologie, Berlin, Germany.,Berlin Institute of Health (BIH), Berlin, Germany
| | - Annette Aigner
- Charité - Universitätsmedizin Berlin, Institut für Biometrie und klinische Epidemiologie, Berlin, Germany.,Berlin Institute of Health (BIH), Berlin, Germany
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Carreras G, Lugo A, Gallus S, Cortini B, Fernández E, López MJ, Soriano JB, López-Nicolás A, Semple S, Gorini G. Burden of disease attributable to second-hand smoke exposure: A systematic review. Prev Med 2019; 129:105833. [PMID: 31505203 DOI: 10.1016/j.ypmed.2019.105833] [Citation(s) in RCA: 69] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Revised: 08/30/2019] [Accepted: 09/05/2019] [Indexed: 10/26/2022]
Abstract
Our aim was to provide a systematic review of studies on the burden of disease due to second-hand smoke (SHS) exposure, reviewing methods, exposure assessment, diseases causally linked to SHS, health outcomes, and estimates available to date. A literature review of studies on the burden of disease from SHS exposure, available in PubMed and SCOPUS, published 2007-2018 in English language, was carried out following the PRISMA recommendations. Overall, 588 studies were first identified, and 94 were eligible. Seventy-two studies were included in the systematic review. Most of them were based on the comparative risk assessment approach, assessing SHS exposure using mainly surveys on exposure at home/workplaces. Diseases more frequently studied were: lung cancer, ischemic heart disease, stroke, chronic obstructive pulmonary disease, asthma and breast cancer in adults; lower respiratory tract infection, otitis media, asthma, sudden infant death syndrome and low birth weight in children. The SHS exposure assessment and the reported population attributable fractions (PAF) were largely heterogeneous. As an example, the PAF from lung cancer varied between 0.6% and 20.5%. Moreover, PAF were estimated applying relative risks and SHS exposures with no consistent definitions or with different age classes. The research gap on the SHS exposure burden is shrinking. However, estimates are not yet available for a number of countries, particularly the Middle Eastern and African countries, and not all diseases with the strongest evidence of causation, such as sudden infant death syndrome, have been explored. Moreover, in some cases the applied methodology revealed relatively low quality of data.
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Affiliation(s)
- Giulia Carreras
- Oncologic Network, Prevention and Research Institute (ISPRO), via Cosimo il Vecchio 2, 50139 Florence, Italy.
| | - Alessandra Lugo
- Istituto di Ricerche Farmacologiche Mario Negri IRCCS (IRFMN), Via La Masa 19, 20156 Milan, Italy
| | - Silvano Gallus
- Istituto di Ricerche Farmacologiche Mario Negri IRCCS (IRFMN), Via La Masa 19, 20156 Milan, Italy
| | - Barbara Cortini
- Oncologic Network, Prevention and Research Institute (ISPRO), via Cosimo il Vecchio 2, 50139 Florence, Italy
| | - Esteve Fernández
- Catalan Institute of Oncology (ICO), Granvia de L'Hospitalet, 199-203, PC 08908 L'Hospitalet de Llobregat, Spain; Bellvitge Biomedical Research Institute (IDIBELL), Granvia de L'Hospitalet, 199, PC 08908 L'Hospitalet de Llobregat, Spain; Department of Clinical Sciences, Campus de Bellvitge, School of Medicine and Health Sciences, University of Barcelona, Feixa Llarga, s/n, PC 08907 L'Hospitalet de Llobregat, Spain
| | - Maria José López
- Public Health Agency of Barcelona (ASPB). Pl. Lesseps, 1, PC 08023 Barcelona, Spain; CIBER Epidemiologia y Salud Pública (CIBERESP), Av. Monforte de Lemos, 3-5, Pabellón 11, Planta 0. PC 28029, Madrid, Spain; Institut d'Investigació Biomèdica de Sant Pau (IIB Sant Pau), Sant Antoni Maria Claret, 167, PC 08025 Barcelona, Spain
| | - Joan B Soriano
- Hospital Universitario La Princesa (IISP), Diego de León, 62 1st floor, PC 28006 Madrid, Spain
| | - Angel López-Nicolás
- Polytechnic University of Cartagena (UPCT), Plaza Cronista Isidoro Valverde, s/n, PC 30202 Cartagena, Spain
| | - Sean Semple
- Faculty of Health Sciences and Sport, University of Stirling, Stirling FK9 4LA, Scotland, UK
| | - Giuseppe Gorini
- Oncologic Network, Prevention and Research Institute (ISPRO), via Cosimo il Vecchio 2, 50139 Florence, Italy
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Janot K, Charbonnier G, Boustia F, Lima Maldonado I, Bibi R, Pucheux J, Herbreteau D. [Stroke prevention]. Presse Med 2019; 48:655-663. [PMID: 31151843 DOI: 10.1016/j.lpm.2019.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Accepted: 05/02/2019] [Indexed: 11/26/2022] Open
Abstract
Prevention is essential to stroke management because of the high risk of recurrence. Stroke incidence is increased by known risk factors, which can be prevented. Cardiovascular prevention after stroke or TIA also includes aetiology-specific treatment, when it is known. Endovascular treatment is not indicated as a first-line treatment for atheromatous cervical or intracranial stenosis. Endovascular or surgical treatment is not indicated as first-line treatment for cervical arterial dissection because of its minor risk of stroke recurrence.
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Affiliation(s)
- Kevin Janot
- Hôpital Bretonneau, université François-Rabelais de Tours, centre hospitalier régional universitaire de Tours, service de neuroradiologie interventionnelle, 37000 Tours, France.
| | - Guillaume Charbonnier
- Centre hospitalier universitaire de Besançon, service de neurologie, 25000 Besançon, France
| | - Fakhreddine Boustia
- Hôpital Bretonneau, université François-Rabelais de Tours, centre hospitalier régional universitaire de Tours, service de neuroradiologie interventionnelle, 37000 Tours, France
| | - Igor Lima Maldonado
- Hôpital Bretonneau, université François-Rabelais de Tours, centre hospitalier régional universitaire de Tours, service de neuroradiologie interventionnelle, 37000 Tours, France
| | - Richard Bibi
- Hôpital Bretonneau, université François-Rabelais de Tours, centre hospitalier régional universitaire de Tours, service de neuroradiologie interventionnelle, 37000 Tours, France
| | - Julien Pucheux
- Hôpital Trousseau, université François-Rabelais de Tours, centre hospitalier régional universitaire de Tours, service de radiologie interventionnelle, 37000 Tours, France
| | - Denis Herbreteau
- Hôpital Bretonneau, université François-Rabelais de Tours, centre hospitalier régional universitaire de Tours, service de neuroradiologie interventionnelle, 37000 Tours, France
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Health Impact Assessment for Second-Hand Smoke Exposure in Germany--Quantifying Estimates for Ischaemic Heart Diseases, COPD, and Stroke. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:198. [PMID: 26861366 PMCID: PMC4772218 DOI: 10.3390/ijerph13020198] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/10/2015] [Revised: 01/21/2016] [Accepted: 02/03/2016] [Indexed: 12/22/2022]
Abstract
Evidence of the adverse health effects attributable to second-hand smoke (SHS) exposure is available. This study aims to quantify the impact of SHS exposure on ischaemic heart diseases (IHD), chronic obstructive pulmonary diseases (COPD), and stroke in Germany. Therefore, this study estimated and forecasted the morbidity for the three outcomes in the German population. Furthermore, a health impact assessment was performed using DYNAMO-HIA, which is a generic software tool applying a Markov model. Overall 687,254 IHD cases, 231,973 COPD cases, and 288,015 stroke cases were estimated to be attributable to SHS exposure in Germany for 2014. Under the assumption that the population prevalence of these diseases and the prevalence of SHS exposure remain constant, the total number of cases will increase due to demographic aging. Assuming a total eradication of SHS exposure beginning in 2014 leads to an estimated reduction of 50% in cases, compared to the reference scenario in 2040 for all three diseases. The results highlight the relevance of SHS exposure because it affects several chronic disease conditions and has a major impact on the population’s health. Therefore, public health campaigns to protect non-smokers are urgently needed.
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Kernan WN, Ovbiagele B, Black HR, Bravata DM, Chimowitz MI, Ezekowitz MD, Fang MC, Fisher M, Furie KL, Heck DV, Johnston SCC, Kasner SE, Kittner SJ, Mitchell PH, Rich MW, Richardson D, Schwamm LH, Wilson JA. Guidelines for the prevention of stroke in patients with stroke and transient ischemic attack: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke 2014; 45:2160-236. [PMID: 24788967 DOI: 10.1161/str.0000000000000024] [Citation(s) in RCA: 2851] [Impact Index Per Article: 285.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
The aim of this updated guideline is to provide comprehensive and timely evidence-based recommendations on the prevention of future stroke among survivors of ischemic stroke or transient ischemic attack. The guideline is addressed to all clinicians who manage secondary prevention for these patients. Evidence-based recommendations are provided for control of risk factors, intervention for vascular obstruction, antithrombotic therapy for cardioembolism, and antiplatelet therapy for noncardioembolic stroke. Recommendations are also provided for the prevention of recurrent stroke in a variety of specific circumstances, including aortic arch atherosclerosis, arterial dissection, patent foramen ovale, hyperhomocysteinemia, hypercoagulable states, antiphospholipid antibody syndrome, sickle cell disease, cerebral venous sinus thrombosis, and pregnancy. Special sections address use of antithrombotic and anticoagulation therapy after an intracranial hemorrhage and implementation of guidelines.
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Prevalence of thrombophilic gene polymorphisms (FVL G1691A and MTHFR C677T) in patients with myocardial infarction. EGYPTIAN JOURNAL OF MEDICAL HUMAN GENETICS 2014. [DOI: 10.1016/j.ejmhg.2014.02.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
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Abstract
This study aimed to identify the main risk factors of cerebrovascular accident (CVA) in Jordan. Identification of risk factors may help to reduce the incidence of CVA. A form was prepared for data collection which consisted of two parts to gather biodata and the incidence of risk factors. A sample of 200 patients with CVA (60% men) were randomly selected from various areas of Jordan. An age, region distribution, and gender-matched sample were selected to serve as control. Hypertension in the experimental group (66%) was significantly higher than the control group (32%) p < 0.001. Half of the subjects with stroke had diabetes compared to 22% of the control group (p < 0.001). Cardiovascular diseases were found in 29% of subjects with CVA compared to 14% in the control group (p < 0.001). About 27% of the CVA group had hyperlipidemia in comparison to 13% in the controls (p < 0.002). Smokers represented 54% of the experimental group compared to 30% of the control group (p < 0.05). An important finding in the present study was that about half of the selected subjects with strokes were under the age of 60 years. In conclusion, hypertension, diabetes, cardiovascular diseases, hyperlipidemia, and smoking are risk factors for CVA in Jordan.
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Affiliation(s)
- Mohammad A Auais
- School of Physical & Occupational therapy, Faculty of Medicine, McGill University, Quebec, Canada
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Stroke and Substance Abuse. Stroke 2011. [DOI: 10.1016/b978-1-4160-5478-8.10042-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Furie KL, Kasner SE, Adams RJ, Albers GW, Bush RL, Fagan SC, Halperin JL, Johnston SC, Katzan I, Kernan WN, Mitchell PH, Ovbiagele B, Palesch YY, Sacco RL, Schwamm LH, Wassertheil-Smoller S, Turan TN, Wentworth D. Guidelines for the prevention of stroke in patients with stroke or transient ischemic attack: a guideline for healthcare professionals from the american heart association/american stroke association. Stroke 2010; 42:227-76. [PMID: 20966421 DOI: 10.1161/str.0b013e3181f7d043] [Citation(s) in RCA: 1133] [Impact Index Per Article: 80.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
The aim of this updated statement is to provide comprehensive and timely evidence-based recommendations on the prevention of ischemic stroke among survivors of ischemic stroke or transient ischemic attack. Evidence-based recommendations are included for the control of risk factors, interventional approaches for atherosclerotic disease, antithrombotic treatments for cardioembolism, and the use of antiplatelet agents for noncardioembolic stroke. Further recommendations are provided for the prevention of recurrent stroke in a variety of other specific circumstances, including arterial dissections; patent foramen ovale; hyperhomocysteinemia; hypercoagulable states; sickle cell disease; cerebral venous sinus thrombosis; stroke among women, particularly with regard to pregnancy and the use of postmenopausal hormones; the use of anticoagulation after cerebral hemorrhage; and special approaches to the implementation of guidelines and their use in high-risk populations.
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Hauri DD, Lieb CM, Rajkumar S, Kooijman C, Sommer HL, Röösli M. Direct health costs of environmental tobacco smoke exposure and indirect health benefits due to smoking ban introduction. Eur J Public Health 2010; 21:316-22. [DOI: 10.1093/eurpub/ckq142] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Rigau Comas D, Álvarez-Sabin J, Gil Núñez A, Abilleira Castells S, Borras Pérez FX, Armario García P, Arrieta Antón E, Marañón Fernández E, Martí Canales JC, Morales Ortiz A, Reverter Calatayud JC, Sancristóbal Velasco E, Solà Arnau I, Alonso Coello P. Guía de práctica clínica sobre prevención primaria y secundaria del ictus. Med Clin (Barc) 2009; 133:754-62. [DOI: 10.1016/j.medcli.2009.02.037] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2008] [Accepted: 02/03/2009] [Indexed: 10/20/2022]
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Lawrence M, Kerr S, Watson HE, Jackson J, Brownlee MG. A summary of the guidance relating to four lifestyle risk factors for recurrent stroke. ACTA ACUST UNITED AC 2009. [DOI: 10.12968/bjnn.2009.5.10.44671] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
| | - Susan Kerr
- School of Health, Glasgow Caledonian University, G4 0BA
| | | | - Jennie Jackson
- Nutrition and Dietetics, School of Life Sciences, Glasgow Caledonian University, G4 0BA
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Erhardt L. Cigarette smoking: an undertreated risk factor for cardiovascular disease. Atherosclerosis 2009; 205:23-32. [PMID: 19217623 DOI: 10.1016/j.atherosclerosis.2009.01.007] [Citation(s) in RCA: 175] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2008] [Revised: 01/07/2009] [Accepted: 01/08/2009] [Indexed: 12/11/2022]
Abstract
Smoking and other forms of tobacco use are major risk factors for cardiovascular disease. The effect of cigarette smoking on cardiovascular health is evident even at the lowest levels of exposure. Yet, the adverse effects of smoking are reversible, with cardiovascular risk decreasing substantially within the first 2 years of smoking cessation. Significantly, the mortality from coronary heart disease is reduced more through smoking cessation than by other secondary preventive therapies such as cholesterol lowering. Smoking cessation is a highly effective way to improve cardiovascular health in smokers and extremely cost-effective. However, smoking cessation therapies are not implemented maximally if they are implemented at all, perhaps because smoking is seen as a lifestyle choice or because smokers frequently relapse, as indicated by very low long-term quit rates. Too often, healthcare professionals, including lipidologists and cardiologists, do little to address their patients' smoking status, in spite of its impact on cardiovascular health. With the advent of new therapies to treat the nicotine addiction that results from smoking and other tobacco use, it is hoped that physicians will be more proactive in encouraging and implementing smoking cessation programs for their patients, with the goal of increasing long-term quit rates, and reducing the morbidity and mortality associated with cardiovascular disease.
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Affiliation(s)
- Leif Erhardt
- Department of Cardiology, University of Lund, Malmö University Hospital, Malmö, Sweden
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