期刊论文详细信息
BMC Public Health
Smoking cessation and the risk of cardiovascular disease outcomes predicted from established risk scores: Results of the Cardiovascular Risk Assessment among Smokers in Primary Care in Europe (CV-ASPIRE) Study
Franco Mondello Malvestiti2  Mark Nixon4  Andrew Burgess4  Renzo Imperiali1  Hugo Rol3  Christos Lionis5  Pablo Mallaina2 
[1] Primary Care Varese ASL, distretto di Tradate, Italy;Primary Care BU Europe, Pfizer, Walton Oaks, Pfizer, Walton Oaks, Dorking Road, Surrey KT20 7NS, UK;Bennebroek Primary Care Center, Bennebroek, The Netherlands;Real-World and Late Phase Research, Quintiles, Reading, UK;Clinic of Social and Family Medicine, Faculty of Medicine, University of Crete, Crete, Greece
关键词: ASPIRE;    Progetto;    SCORE;    Framingham;    Cessation;    Smoking;    Model;    Europe;    Diseases;    Cardiovascular;   
Others  :  1162319
DOI  :  10.1186/1471-2458-13-362
 received in 2012-10-04, accepted in 2013-04-12,  发布年份 2013
PDF
【 摘 要 】

Background

Smoking is a major risk factor for cardiovascular disease (CVD). This multicenter, cross-sectional survey was designed to estimate the cardiovascular (CV) risk attributable to smoking using risk assessment tools, to better understand patient behaviors and characteristics related to smoking, and characterize physician practice patterns.

Methods

1,439 smokers were recruited from Europe during 2011. Smokers were ≥40 years old, smoked > 10 cigarettes/day and had recent measurements on blood pressure and lipids. CV risk was calculated using the SCORE system, Framingham risk equations, and Progetto CUORE model. The CV risk attributable to smoking was evaluated using a simulated control (hypothetical non-smoker) with identical characteristics as the enrolled smoker. Risks assessed included CV mortality, coronary heart disease (CHD), CVD and hard CHD. Demographics, comorbidities, primary reasons for consultation, behavior towards previous attempts to quit, and interest in smoking cessation was assessed. Dependence on nicotine was evaluated using the Fagerström Test for Nicotine Dependence. GP practice patterns were assessed through a questionnaire.

Results

The prediction models consistently demonstrated a high CV risk attributable to smoking. For instance, the SCORE model demonstrated that this study population of smokers have a 100% increased probability of death due to cardiovascular disease in the next 10-years compared to non-smokers. A considerable amount of patients would like to hear from their GP about the different alternatives available to support their quitting attempt.

Conclusions

The findings of this study reinforce the importance of smoking as a significant predictor of long-term cardiovascular events. One of the best gains in health could be obtained by tackling the most important modifiable risk factors; these results suggest smoking is among the most important.

【 授权许可】

   
2013 Mallaina et al.; licensee BioMed Central Ltd.

【 预 览 】
附件列表
Files Size Format View
20150413062106150.pdf 212KB PDF download
【 参考文献 】
  • [1]World Health Organization: WHO Report on the Global Tobacco Epidemic World Health Organization: WHO Report on the Global Tobacco Epidemic; 2008. [http://www.who.int/tobacco/mpower/en/ webcite]
  • [2]European Heart Network: CVD Statistics. [http://www.ehnheart.org/cvd-statistics.html webcite]
  • [3]Price JF, Mowbray PI, Lee AJ, Rumley A, Lowe GD, Fowkes FG: Relationship between smoking and cardiovascular risk factors in the development of peripheral arterial disease and coronary artery disease: Edinburgh Artery Study. Eur Heart J 1999, 20:344-53.
  • [4]Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC): Guidelines for the Management of Arterial Hypertension. J Hypertens 2007, 25:87-1105.
  • [5]Task Force on Diabetes and Cardiovascular Diseases of the European Society of Cardiology (ESC) and of the European Association for the Study of Diabetes (EASD): Guidelines on diabetes, pre-diabetes and cardiovascular disease: full text. Eur Heart J 2007, 9:1-74.
  • [6]Yusuf S, Hawken S, Ounpuu S, Dans T, Avezum A, Lanas F, McQueen M, Budaj A, Pais P, Varigos J, Lisheng L: INTERHEART Study Investigators: Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): case–control study. Lancet 2004, 364:937-952.
  • [7]National Cholesterol Education Program: Risk Assessment Tool for Estimating 10-year Risk of Developing Hard CHD (Myocardial Infarction and Coronary Death). [http://hp2010.nhlbihin.net/atpIII/calculator.asp?usertype=prof webcite]
  • [8]Wilson PW, D'Agostino RB, Levy D, Belanger AM, Silbershatz H, Kannel WB: Prediction of coronary heart disease using risk factor categories. Circulation 1998, 97(18):1837-47.
  • [9]D'Agostino RB Sr, Vasan RS, Pencina MJ, Wolf PA, Cobain M, Massaro JM, Kannel WB: General cardiovascular risk profile for use in primary care: the Framingham Heart Study. Circulation 2008, 117:743-53.
  • [10]D'Agostino RB Sr, Grundy S, Sullivan LM, Wilson P: Validation of the Framingham coronary heart disease prediction scores: results of a multiple ethnic groups investigation. JAMA 2001, 286(2):180-187.
  • [11]Murabito JM, D'Agostino RB, Silbershatz H, Wilson WF: Intermittent claudication. A risk profile from the Framingham Heart Study. Circulation 1997, 96(1):44-9.
  • [12]D'Agostino RB, Russell MW, Huse DM, Ellison RC, Silbershatz H, Wilson PW, Hartz SC: Primary and subsequent coronary risk appraisal: new results from the Framingham Study. Am Heart J 2000, 139(2 Pt 1):272-281.
  • [13]Conroy RM, Pyörälä K, Fitzgerald AP, Sans S, Menotti A, De Backer G, De Bacquer D, Ducimetière P, Jousilahti P, Keil U, Njølstad I, Oganov RG, Thomsen T, Tunstall-Pedoe H, Tverdal A, Wedel H, Whincup P, Wilhelmsen L, Graham IM: SCORE project group: Estimation of ten-year risk of fatal cardiovascular disease in Europe: the SCORE project. Eur Heart J 2003, 24(11):987-1003.
  • [14]Perk J, De Backer G, Gohlke H, Graham I, Reiner Z, Verschuren M, Albus C, Benlian P, Boysen G, Cifkova R, Deaton C, Ebrahim S, Fisher M, Germano G, Hobbs R, Hoes A, Karadeniz S, Mezzani A, Prescott E, Ryden L, Scherer M, Syvänne M, Scholte Op Reimer WJM, Vrints C, Wood D, Luis Zamorano J, Zannad F: European Guidelines on cardiovascular disease prevention in clinical practice (version 2012). Eur Heart J 2012, 33:1635-1701.
  • [15]Palmieri L, Panico S, Vanuzzo D, Ferrario M, Pilotto L, Sega R, Cesana G, Giampaoli S, per il Gruppo di Ricerca del Progetto CUORE: La valutazione del rischio cardiovascolare globale assoluto: il punteggio individuale del Progetto CUORE. Ann 1st Super Sanita 2004, 40(4):393-399.
  • [16]Sadowski J, Ruffieux C, Cornuz J: Self-reported smoking cessation activities among Swiss primary care physicians. BMC Fam Pract 2009, 10:22. BioMed Central Full Text
  • [17]gp-training.net - a GP education and training resource Smoking cessation facts; [http://www.gp-training.net/protocol/misc/smoking/facts.htm webcite]
  • [18]McEwen A, West R, Owen L, Raw M: General practitioners’ views on and referral to NHS smoking cessation services. Public Health 2005, 119(4):262-268.
  • [19]O’Sullivan J: An evaluation of general practitioners’ interactions with the smoking cessation service and the impact of a desktop resource on the service. In MA thesis. Cork: University College Cork Department of Epidemiology and Public Health. National University of Ireland; 2006.
  • [20]Dekker HM, Looman CWN, Adriaanse HP, van der Maas PJ: Prevalence of smoking in physicians and medical students, and the generation effect in The Netherlands. Soc Sci Med 1993, 36(6):817-822.
  • [21]Stead M, Angus K, Holme I, Cohen D, Tait G: PESCE European Research Team: Factors influencing European GPs’ engagement in smoking cessation: a multi-country literature review. Br J GenPract 2009, 59(566):682-690.
  • [22]Prignot J, Bartsch P, Vermeire P, Jamart J, Wanlin M, Uydebrouck M, Thijs J: Physician’s involvement in the smoking cessation process of their patients. Results of a 1998 survey among 4,643 Belgian physicians. Acta Clinica Belgica 2000, 55(5):266-275.
  • [23]Lennox AS, Taylor R: Smoking cessation activity within primary health care in Scotland: present constraints and their implications. Health Education Journal 1995, 54(1):48-60.
  • [24]Brotons C, Björkelund C, Bulc M, Ciurana R, Godycki-Cwirko M, Jurgova E, Kloppe P, Lionis C, Mierzecki A, Piñeiro R, Pullerits L, Sammut MR, Sheehan M, Tataradze R, Thireos EA, Vuchak J: EUROPREV network: Prevention and health promotion in clinical practice: the views of general practitioners in Europe. Prev Med 2005, 40:595-601.
  • [25]Heatherton TF, Kozlowski LT, Frecker RC, Fagerström KO: The Fagerström Test for Nicotine Dependence: a revision of the Fagerström Tolerance Questionnaire. Br J Addict 1991 Sep, 86(9):1119-1127.
  • [26]Kotsoni C, Antonakis N, Markaki A, Lionis C: Do patients with chronic obstructive pulmonary disease receive smoking cessation advice and interventions in rural Crete? Report from a medical audit study. Aust J Rural Health 2008 Dec, 16(6):385-6.
  • [27]Global initiative for chronic obstructive lung disease (GOLD): Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Pulmonary Disease (Revised 2011).    ,  : .
  • [28]Antonakis N, Xylouri I, Alexandrakis M, Cavoura C, Lionis C: Seeking prescribing patterns in rural Crete: a pharmacoepidemiological study from a primary care area. Rural and Remote Health 2006, 6:488.
  • [29]Tonstad S, Johnston A: Cardiovascular risks associated with smoking: a review for clinicians. Eur J Cardiovasc Prev Rehabil 2006 Aug, 13(4):507-14.
  • [30]Yusuf S, Hawken S, Ôunpuu S, Dans T, Avezum A, Lanas F, McQueen M, Budaj A, Pais P, Varigos J, Lisheng L: INTERHEART Study Investigators: Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): case–control study. The Lancet 2004, 364(9438):937-952.
  • [31]Action on Smoking and Health: Stopping smoking: the benefits and aids to quitting. [http://ash.org.uk/files/documents/ASH_116.pdf webcite]
  • [32]Fiore MC, Jaén CR, Baker TB, Bailey WC, Benowitz NL, Curry SJ, Dorfman SF, Froelicher ES, Goldstein MG, Healton CG, Henderson PN, Heyman RB, Koh HK, Kottke TE, Lando HA, Mecklenburg RE, Mermelstein RJ, Mullen PD, Orleans CT, Robinson L, Stitzer ML, Tommasello AC, Villejo L, Wewers ME: Treating Tobacco Use and Dependence, Update. Clinical Practice Guideline. Rockville, MD: U.S. Department of Health and Human Services. Public Health Service 2008.
  文献评价指标  
  下载次数:15次 浏览次数:57次