Jt. Powell et al., RISK-FACTORS ASSOCIATED WITH THE DEVELOPMENT OF PERIPHERAL ARTERIAL-DISEASE IN SMOKERS - A CASE-CONTROL STUDY, Atherosclerosis, 129(1), 1997, pp. 41-48
Purpose and method: A hospital based case-control study was designed t
o investigate what aspects of smoking and what co-factors of smoking a
re associated with the development of peripheral arterial disease (PAD
). Cases were 291 smokers, newly referred with PAD, and controls were
828 age and sex matched smokers without PAD. Results: Reported recent
tobacco usage was similar in cases and controls but total tobacco expo
sure was associated with the risk of PAD - adjusted odds ratios (ORs)
increasing with tertile of pack-years smoked to reach 1.63 (95% CI, 1.
11-2.39; P = 0.011), for the highest tertile (> 48 pack-years) compare
d with smokers in the lowest tertile (< 31 pack-years). Cases reported
smoking significantly lower tar and nicotine yield cigarettes than co
ntrols, but tended to inhale more deeply, and had significantly higher
plasma concentrations of cotinine. ORs for PAD were significantly and
independently increased by systolic blood pressure greater than or eq
ual to 160 mmHg (8.1 (5.2-13.0); P < 0.0001), history of hypertension
(2.4 (1.5-3.2); P = 0.0003) and apolipoprotein B > 0.9 g/l(3.8 (2.3-7.
6); P = 0.008). Conclusions: Increased total exposure to tobacco and t
he ability to smoke tobacco in a way which maximises nicotine yield ar
e associated with increased risk of smokers developing PAD. There is n
o evidence that smoking low tar cigarettes reduces this risk, whereas
both hypertension (particularly systolic) and high levels of apolipopr
otein B, increase this risk. (C) 1997 Elsevier Science Ireland Ltd.