吸烟与心血管疾病

1、 中国NEHNS IV (中国心血管疾病危险因素现状IV) 和吸烟相关的死亡的前三位疾病：和吸烟相关的死亡的前三位疾病：国外资料为：国外资料为：COPDCOPD冠心病冠心病肺癌肺癌国内资料为：国内资料为：COPDCOPD肺癌冠心病肺癌冠心病1. Surgeoen Generals Report. Health Consequences of Smoking; 2004. 2. J Natl Cancer Inst. 1993;85(24):1994. 2 3. Crane. Cancer Epidemiol Biomarkers Prev. 1996;5(8):639. -11 4. Mili

2、gi. Am J Ind Med. 1999;36(1):60. 5. Roman. Cerebrovasc Dis, 2005;20(Suppl 2):91-8. 6. Willigendael. J Vasc Surg. 2004;40:1158. -107. Yang. BMJ. 1999;319:143-9Lavi et al. Circulation. 2007;115:2621-2627-6; /HIC/Topics/Diag/diangio.cfm. Accessed June 14, 2007.右冠状动脉粥样硬化

3、右冠状动脉粥样硬化Sambola et al. Circulation. 2003;107:973-977-5.Factor Xa (FXa) pmol/L/minP=.0032172830100200300400吸烟者吸烟前（2支烟）吸烟者吸烟2h后(2支烟)Barua et al. Circulation. 2001;104:1905-1910.50000NonsmokersN=8Current SmokersN=154000300020001000NO Concentration (nmol/L)P.000112663613Lavi et al. Circulation. 2007;11

4、5:2621-2627.Endothelial Dysfunction (%)P=.03604530150NonsmokersEx-smokersCurrentSmokersN=11546%34%35%N=766Waters et al. Circulation. 1996;94:614-621.-7 已有病变加重的发生率已有病变加重的发生率吸烟者N=90非吸烟者N=240P=.002患者百分率新病变发生率新病变发生率吸烟者P=.007非吸烟者患者百分率F/U2 YearsaThe ratio of the odds of development of disease in exposed p

5、ersons to the odds of development of disease in nonexposed persons.Teo. Lancet. 2006;368:647-658.-12OR (95% CI)a109876543210年龄年龄407070非吸烟者戒烟者吸烟20支/天吸烟1-19支/天Yusuf S et al . Lancet. 2004;364:937-52-13a The probability of an event (developing a disease) occurring in exposed people compared with the pr

6、obability of the event in nonexposed people. Adjusted for age.Willett et al. N Engl J Med. 1987;317(21):1303-1309.吸烟者每日吸烟量吸烟者每日吸烟量相对风险可信区间95aThe probability of an event (developing a disease) occurring in exposed people compared with the probability of the event in nonexposed people. Adjusted for ag

7、e.Wannamethee et al. Circulation. 1995;91:1749-1756.1.02.30.01.02.03.04.0不吸烟者吸烟者相对风险可信区间95aThe probability of an event (developing a disease) occurring in exposed people compared with the probability of the event in nonexposed people. Adjusted for age, follow-up period, history of diabetes, hyperten

8、sion, high cholesterol levels, and relative weight (in 5 categories).Colditz et al. N Engl J Med. 1988;318(15):937-941.1-1415-24不吸烟者25吸烟者每日吸烟量（支）吸烟者每日吸烟量（支）相对风险可信区间95aTwenty-year age-adjusted mortality per 10,000 person-years for men. P.014 for trend. Hart et al. Stroke. 1999;30:1999-2007.15-241-152

9、5吸烟者每日吸烟量（支）吸烟者每日吸烟量（支）死亡率/10000人*年Freund KM, The Framingham Study: 34 years of follow-up. Ann Epidemiol 1993; 3:417-424Witteman JC,. Circulation 1993; 88:2156-2162-15Wilmink TB, J Vasc Surg 1999; 30:1099-1105-141. CDC. Surgeon General Report 2004 -22. American Cancer Society. Guide to Quitting Smok

10、ing2006-1 肺功能改善减少咳嗽鼻窦充血呼吸急促等 3 3个月个月肺Ca发生率是继续吸烟者的30-50% CAD危险减少50%CAD危险与正常不吸烟者相似卒中危险恢复到正常不吸烟者水平1 1年年5 5 年年10 10 年年15 15 年年戒烟戒烟aThe ratio of the odds of development of disease in exposed persons to the odds of development of disease in nonexposed persons. Adjusted for sex, region, diet, alcohol, phys

11、ical activity, consumption of fruits, vegetables, and alcohol.Adapted from Teo. Lancet. 2006;368:647-658.-12比值比可信区间95 aAbstention period of 3 years. Hallstrom et al. N Engl J Med. 1986;314:271-275.3年内发生率年内发生率 (%)P=.038心脏骤停反复发作心脏骤停反复发作2719051015202530吸烟者戒烟者aN=310aThe probability of an event (developi

12、ng a disease) occurring in exposed people compared with the probability of the event in nonexposed people. Adjusted for age and treatment assignment.Robbins et al. Ann Intern Med. 1994;120(6):458-462.-16不吸烟者戒烟者吸烟者(20支/日)吸烟者(20 支/日）P .0001(趋势趋势)相对风险可信区间95Jonason et al. Acta Med Scand. 1987;221:253-260.年年累积静息痛累积静息痛 (