Highlights
- •Smoking is significantly associated with the risk of cardiovascular disease (CVD).
- •Alcohol consumption is significantly associated with the risk of CVD.
- •Women have greater risk of CVD than do men among Korean adults with elevated BP.
Abstract
Background and aims
Cardiovascular 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 results
Adults 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.
Conclusion
Smoking 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.
Keywords
Abbreviations:
CVD (Cardiovascular disease), BP (Blood pressure), NHIS-NSC 2.0 (National Health Insurance Service-National Sample Cohort version 2.0), ICD (International Classification of Diseases), T2D (Type 2 diabetes), BMI (Body mass index), FBG (Fasting blood glucose), NSND (Nonsmoking nondrinking), HR (Hazard ratio), CI (Confidence interval)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: June 10, 2022
Accepted:
June 6,
2022
Received in revised form:
May 24,
2022
Received:
November 20,
2021
Handling Editor: Dr. A. SianiIdentification
Copyright
© 2022 The Italian Diabetes Society, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. All rights reserved.
