August 20, 2019

Quitting smoking associated with lower risk of cardiovascular disease

A new Vanderbilt study documents the great incentive for current smokers to quit.

A Vanderbilt study recently published in the Journal of the American Medical Association documents the great incentive for current smokers to quit.

Among heavy smokers – meaning those with at least a 20 year smoking history – quitting smoking was associated with a 39% lower risk of cardiovascular disease (CVD) within five years compared to continued heavy smoking. However, it took at least five to 10 and perhaps up to 25 years after quitting for CVD risk to become as low as that of a similar person who has never smoked.

“Previous studies have shown the association between quitting and reduced CVD risk,” said lead author Meredith Duncan, MA, who led the analyses as part of the Division of Cardiovascular Medicine at Vanderbilt University Medical Center and who is a PhD candidate in the Department of Epidemiology at Vanderbilt University. “But the current Atherosclerotic CVD Risk Calculator, which is routinely used in clinical practice, considers former smokers’ risk to be similar to that of never smokers after five years of cessation, which is not consistent with these findings.”

Meredith Duncan, MA

Cigarette smoking is responsible for 20 percent of CVD deaths in the United States, the study notes.

The research used data from the Framingham Heart Study, a longitudinal study of men and women from Framingham, Massachusetts, which began enrollment of the Original cohort in 1948 and now includes their children (Offspring cohort) and grandchildren (Generation 3 cohort) as well as multiethnic cohorts (Omni cohorts).

The study used prospective data from 1954 through 2014 from 8,770 participants — 3,805 from the Original cohort and 4,965 from the Offspring cohort — to determine the effect of lifetime smoking and smoking cessation on the risk of CVD. CVD includes myocardial infarction, stroke, CVD death and heart failure.

The Original cohort was examined every two years and the Offspring cohort every four years, and the study continues to this day. This investigation included information on up to 28 assessments of smoking on Original cohort members and up to nine assessments on Offspring cohort members.

“The Framingham Heart Study provides particularly robust data on lifetime smoking history,” Duncan said. “Our team leveraged this unique opportunity to document what happens to CVD risk after quitting smoking relative to people who continued to smoke and to those who never smoked.”

Other authors of the study were Matthew Freiberg, MD, MSc; Robert Greevy, PhD; Suman Kundu, DSc, MSc; Ramachandran Vasan, MD; and Hilary Tindle, MD, MPH.

Tindle, medical sirector of the VUMC Tobacco Treatment Service, founding director of the Vanderbilt Center for Tobacco Addiction and Lifestyle (ViTAL) and senior author of the study, urges smokers to act on these study results by putting out their cigarettes.

“The cardiovascular system begins to heal relatively quickly after quitting smoking, even for people who have smoked heavily over decades,” she said. “Full recovery could take years, so now is a great time to quit smoking and take other steps toward heart health.”

To view the article, go here.