Cor Vasa 2004, 45(9):409-417

The risk profiles of smokers, ex-smokers, and non-smokers in a population random sample of the Czech Republic

Zdenka Škodová^1,*, Renata Cífková¹, Rudolf Poledne², Věra Lánská³, Petr Stávek², Věra Adámková¹, Eva Novozámská¹, Marie Jozífová¹, Helena Pistulková¹, Markéta Plášková¹, Zdenka Petržilková¹, Ludmila Peterková¹, Daniel Palouš¹, Markéta Galovcová¹

¹ Pracoviště preventivní kardiologie

² Laboratoř pro výzkum aterosklerózy

³ Oddělení lékařské statistiky, Institut klinické a experimentální medicíny, Praha, Česká republika

Aim:
One of the mechanisms of action of tobacco smoking on cardiovascular morbidity and mortality is an effect on lipid and carbohydrate metabolism and on some anthropometric parameters, which partly persists after smoking cessation. The aim of our study was to analyze and compare the lipid profiles of smokers, ex-smokers, and never-smokers in a population random sample of nine districts of the Czech Republic.


Patients and method:
A survey of risk factors was undertaken in the 2000-2001 in a 1% population random sample aged 25-64 years resident in Benešov, Cheb, Chrudim, Jindřichův Hradec, Kroměříž, Litoměřice, Pardubice, Plzeň-město, and Praha-východ districts. Smoking habits were determined during an interview by a physician with probands using a standard questionnaire. Biochemical analyses (lipids, glycemia) were performed using enzymatic methods with a COBAS MIRA Roche analyzer (Basel, Switzerland). Three blood pressure readings were obtained by means of a mercury sphygmomanometer on the right arm in a sitting proband after a 5-minute rest. Methods employed in the MONICA Project were used to obtain anthropometric values.

Results:
Current smokers were shown to have the highest values of the atherogenic index of total cholesterol/HDL-cholesterol (males: current smokers /CS/ - 5.14; ex-smokers /ES/ - within 5 years since smoking cessation - 5.01; over 5 years - 4.87; non-smokers /NS/ - 4.75; p < 0.001; females: CS - 4.29; ES - within 5 years since smoking cessation - 4.08, over 5 years - 4.01; NS - 4.03; p < 0.001). Triglyceride levels were likewise significantly different (males: CS - 2.23 mmol/L; ES - within 5 years 2.26 mmol/L; over 5 years 1.95 mmol/L; NS - 1.76 mmol/L; p < 0.001; females: CS - 1.55 mmol/L; ES within 5 years - 1.45 mmol/L, over 5 years - 1.46 mmol/L; NS - 1.44 mmol/L; p < 0.05). Significantly higher levels of total cholesterol, LDL-cholesterol and non-HDL-cholesterol were only noted in male smokers while lower HDL-cholesterol levels were only seen in female smokers. Compared with current smokers and never-smokers among males, ex-smokers were shown to have higher average body weight, BMI, waist circumference, glycemia, prevalences of obesity, type-2 diabetes mellitus and essential hypertension. No such correlations were observed in female ex-smokers. Adjustment to BMI did not largely change the data.

Conclusions:
Cigarette smoking negatively affects the risk profiles of current and ex-smokers. Male and female smokers were identically shown to have the highest atherogenic index and triglyceride levels. Among males, changes in the risk profiles were also appreciable in ex-smokers being a high-risk group even after successful smoking cessation. Although smoking cessation invariably reduces the risk of cardiovascular morbidity and mortality, activities designed to minimize the prevalence of smoking should underline the need to never start smoking at all.

Keywords: Cigarette smoking; Risk profile; Lipids; Blood pressure; Glycemia; BMI

Published: September 1, 2004  Show citation